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On The Scene

Volume 6, Issue 1

Snakebite is a traumatic injury

Spring through fall is the time to be on the lookout for snakebites. Take extra care with venomous bites from Kansas and western Missouri's pit viper population of rattlesnakes, copperheads and cottonmouths.

Although death from venomous snakebite throughout the U.S. is rare, with fewer than five annually, venomous snakebite is a traumatic injury that can cause irreversible damage. Keep these tips in mind when you respond to snakebite calls.

  • When you arrive on the scene: Calm the patient to reduce anxiety and avoid further injury. Determine where the patient was bitten and when.
  • Treat like a fracture: Isolate and immobilize the affected extremity with a sling or splint, and treat for pain. There's no need to find fang marks or determine if the snake was poisonous.
  • If it looks like shock, treat for shock: A small number of people are allergic to snake venom and may experience anaphylactic shock, which can be more deadly than the snakebite. If the patient exhibits symptoms of shock such as difficulty breathing and hives, treat for shock.
  • Antivenom ASAP: The only treatment for venomous snakebite is antivenom. It prevents further tissue damage but does not reverse damage. Time is important. To minimize damage, transport the patient to the nearest ED that has antivenom. Don't bring the snake to the ED! The same antivenom treats all pit viper bites.
  • No tourniquets or cuts: Never apply a tourniquet or cut between fang marks. Tourniquets don't stop localized damage from pit viper venom. Cutting just adds to the injury and increases risk of infection.
  • Don't treat and release: Even if there are no symptoms, take the patient to the ED. Patients may be observed for up to eight hours to ensure no symptoms develop.

About venomous snakebite

  • 20-30% of poisonous snakebites are dry, with no injected venom.
  • 80% of snakebites are on extremities – hands, arms, feet and legs.
  • 99% of pit viper bites with venom result in local pain and swelling.
  • Rarely, excess bleeding and neuromuscular issues may occur.
  • Snakebite usually results from provoking the snake. Alcohol use is frequently involved.

To learn about The University of Kansas Hospital's emergency services, visit kumed.com/emergency.

~ Stephen Thornton, MD

Burn center reaccredited

Our Gene and Barbara Burnett Burn Center and Hurlbut Recovery Pavilion recently received reaccreditation by the American Burn Association endorsed by the American College of Surgeons. The reviewing team, which included two physicians with military burn and trauma experience, visited in late 2014. We were fully reaccredited as both an adult and pediatric burn center. We are still the region's only accredited burn center, the most experienced and offer the most comprehensive range of services.

The review team praised strengths, including our burn survivor support programs and our SOAR program (Survivors Offering Assistance in Recovery), where burn survivors speak to and help current patients. Team members said our performance improvement program is "fantastic," gave kudos to our educational outreach and especially liked that we don't go on diversion for burn patients. Reviewers also said our cost reduction strategy is so effective it should be published. Their review found no deficiencies in care.

~ Tracy McDonald, RN, MSN, CCRN-K, NEA-BC

Meet LifeFlight Eagle

LifeFlight Eagle is a nonprofit organization that provides critical-care helicopter transport to patients throughout a 32,000-square-mile service area in eastern Kansas and central and western Missouri. From its four base locations surrounding Kansas City (Harrisonville, Odessa, Clinton and Trenton, Missouri), the department performs an average of 1,300 patient transports each year.

LifeFlight Eagle has:

  • 27 paramedics, 25 RNs and 17 pilots
  • Two Bell 407 and two Bell 407GX helicopters
  • One twin-engine EC-145 helicopter dedicated to pediatric calls

Flights are in response to EMS requests and transfer requests between community hospitals and tertiary care centers in Kansas City, Kansas; Columbia, Springfield and Kansas City, Missouri; and Des Moines, Iowa. The organization also operates an aircraft specifically equipped and staffed for critical-care pediatrics, serving communities in Kansas, Missouri, Oklahoma, Nebraska and Iowa.

LifeFlight Eagle provides continuing education and AHA classes to community hospitals, fire departments and EMS agencies, and presentations at community health fairs and high school docudramas. The organization recently partnered with The University of Kansas Hospital to provide stroke education to EMTs and paramedics in Linn County, Kansas. To enhance continuity of care and improve patient outcomes, LifeFlight Eagle participates in ongoing service drills and partners with hospitals and EMS agencies to conduct regular quality assurance reviews.

To learn more, visit lifeflighteagle.org.