Snake-Venom and Insect-Venom Extractors: An Unproved Therapy

Ga, Gellert

doi:10.1056/nejm199210293271820

Cited by 17 publications

(3 citation statements)

References 2 publications

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“…The conspicuous lack of independently reviewed data has resulted in their wide-spread criticism [ 84 , 85 , 86 ]. In contrast, a scientific study that examined the performance of a mechanical extractor using human volunteers, reported less than 2% of the radiolabeled mock-venom was recovered by the extractor [ 87 ].…”

Section: Inappropriate First-aid and Treatmentmentioning

confidence: 99%

Snakebite: When the Human Touch Becomes a Bad Touch

Fry

2018

Toxins

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Many issues and complications in treating snakebite are a result of poor human social, economic and clinical intervention and management. As such, there is scope for significant improvements for reducing incidence and increasing patient outcomes. Snakes do not target humans as prey, but as our dwellings and farms expand ever farther and climate change increases snake activity periods, accidental encounters with snakes seeking water and prey increase drastically. Despite its long history, the snakebite crisis is neglected, ignored, underestimated and fundamentally misunderstood. Tens of thousands of lives are lost to snakebites each year and hundreds of thousands of people will survive with some form of permanent damage and reduced work capacity. These numbers are well recognized as being gross underestimations due to poor to non-existent record keeping in some of the most affected areas. These underestimations complicate achieving the proper recognition of snakebite’s socioeconomic impact and thus securing foreign aid to help alleviate this global crisis. Antivenoms are expensive and hospitals are few and far between, leaving people to seek help from traditional healers or use other forms of ineffective treatment. In some cases, cheaper, inappropriately manufactured antivenom from other regions is used despite no evidence for their efficacy, with often robust data demonstrating they are woefully ineffective in neutralizing many venoms for which they are marketed for. Inappropriate first-aid and treatments include cutting the wound, tourniquets, electrical shock, immersion in ice water, and use of ineffective herbal remedies by traditional healers. Even in the developed world, there are fundamental controversies including fasciotomy, pressure bandages, antivenom dosage, premedication such as adrenalin, and lack of antivenom for exotic snakebites in the pet trade. This review explores the myriad of human-origin factors that influence the trajectory of global snakebite causes and treatment failures and illustrate that snakebite is as much a sociological and economic problem as it is a medical one. Reducing the incidence and frequency of such controllable factors are therefore realistic targets to help alleviate the global snakebite burden as incremental improvements across several areas will have a strong cumulative effect.

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Section: Inappropriate First-aid and Treatmentmentioning

confidence: 99%

Snakebite: When the Human Touch Becomes a Bad Touch

Fry

2018

Toxins

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“…Bush et al noted necrosis of tissue with resultant tissue loss in two animals treated with extraction, which was not seen in untreated animals [ 13 ]. Some have alleged that manufacturer claims provide a ‘false sense of security,’ and may delay a patient from seeking definitive and effective care [ 16 ]. Instructional inserts on the Sawyer Products B4 Extractor Pump Kit ® (Sawyer Products, Safety Harbor, FL, USA) do provide a warning that ‘The pump is not a replacement for quickly seeking professional medical treatment.’…”

Section: Methodsmentioning

confidence: 99%

First Aid and Pre-Hospital Management of Venomous Snakebites

Parker‐Cote

Meggs

2018

TropicalMed

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Background: Antivenom is the definitive treatment for venomous snakebites, but is expensive and not available in many rural and poorly developed regions. Timely transportation to facilities that stock and administer antivenom may not be available in rural areas with poorly developed emergency medical services. These factors have led to consideration of measures to delay onset of toxicity or alternatives to antivenom therapy. Methods: PubMed searches were conducted for articles on snakebite treatment, or that contained first aid, emergency medical services, tourniquets, pressure immobilization bandages, suction devices, and lymphatic flow inhibitors. Results: The reviewed articles describe how venoms spread after a venomous snakebite on an extremity, list the proposed first aid measures for delaying the spread of venoms, and evaluate the scientific studies that support or refute methods of snakebite first aid. The recommendations for field treatment of venomous snakebites will be discussed. Conclusions: The evidence suggests that pressure immobilization bandages and related strategies are the best interventions to delay onset of systemic toxicity from venomous snakebites but may increase local toxicity for venoms that destroy tissue at the site of the bite, so their use should be individualized to the circumstances and nature of the venom.

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“…These “first-aid kits” often contain antiseptic wipes, blades to make incisions, restriction bands or chords for tourniquets, and a suction device. These commercial kits are typically not approved by regulatory authorities and their use may provide the victim with a false sense of security and lead to further harm( Fry, 2018 ; Gellert, 1992 ).…”

Section: Treatment Strategies For Sbementioning

confidence: 99%