ED

Question 1

Snake bite (ankle) management

Answer 1

• Venom Detection Kit (during first aid leave venom in place untill in venom test, do not clean wound before this)
• Firm dressing (like for sprains) with wide crepe bandage whole limp from toe to above knee
• venous tourniquet.
• splint to immobilise both foot and knee
• ensure oxygen and resus material available
• Antivenom if signs of envenomation
• polyvalent if snake is unknown, otherwise only for the snake that’s causative
• first give 0.25 (adult, 0.01 mg/kg in child) adrenaline
• after 5 minutes antivenom, ensure more adrenaline, anti-histamine and steroid available
• give oral prednisolon 5 days 50 mg OD after antivenom to avoid serum sickness

Question 2

Signs of envenomation of snake

Answer 2

• local tissue necrosis is NOT sign of bite Australian snakes
• headache
• N, V
• muscle weakness: diplopia, local muscle paralysis, breathing difficulties, apnoea
• coagulopathy
• LOC
• ciculatoir collapse

Question 2

Syncope causes

Answer 2

• neurally mediated: vasovagal, vasodepressor, carotid sinus syncope
• orthostatic syncope : volume depletion, drugs, autonomic failure syndromes
• cardiac arrhythmias: brady and tachy
• structural heart disease
• cerebrovascular disease