Basic
laboratory examinations, blood chemistry examination, complete blood count,
blood grouping and cross, prothrombin time, partial thromboplastin time,
platelet count, urinalysis, determination of blood glucose, BUN, and
electrolytes. For
a great bite, do the examination fibrinogen, fragility of red blood cells,
clotting time and clot retraction time.
Management
a. Principle of handling the snake bite victims:
1) Block the absorption and spread of venom.
2) Neutralize can.
3) Treating complications.
b. First aid:
First aid, make sure the area around the safe and snakes have gone looking for medical help right away do not leave the victim. Next do rigt principles, namely:
R: Reassure: Reassure the victim, the victim calm and rest, panic will increase blood pressure and pulse so that the poison would spread more quickly into the body. Sometimes the patient fainted / panic because shocked.
I: Immobilisation: Do not move the victim, the victim instructed not to walk or run. If within 30 minutes of medical help does not come, do technique swathe press (pressure-immoblisation) in the area around the bite (hands or feet) refer to the process pressure immobilization (bandage press).
G: Get: Take the victim to a hospital as soon and as safely as possible.
Q: Tell the Doctor: Inform the doctor signs and symptoms that appear there were any casualties.
c. Pressure immobilization procedures (dressing press):
1) Balut press on the foot:
a) Rest (immobilisasikan) Victim.
b) Dry the bite wound.
c) Use an elastic bandage.
d) Keep the wound lower than the heart.
e) As soon as possible, do dressings from under the base of the toes upward.
f) Let your toes do not bandaged.
g) Do not remove the victim's pants or shirt.
h) Balut circular manner but not fast enough to block blood flow (viewable with a fixed color pink toes).
i) Give the board / pengalas hard throughout the leg.
2) Balut press on hand:
a) Balut of palms upward. (Fingers are not wrapped).
b) Wrap the elbow and arm bent 90 degrees position.
c) Continue wrapping the arm to the base of the arm.
d) Put the board as a fixation.
e) Use mitela to hold hands.
(Foruniverse, Nursing., 2010. Snake Bite First Aid, (Online), http://nursing foruniverse. Blogspot. Com/2010/01/pertolongan-pertama-pada-gigitan-ular_18.html, accessed July 17, 2011).
d. Management further
1) & rgin-bottom: .0001 pt; margin-bottom: 0cm; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent:-35.45pt; "> 5) ABU 2 flacon in NaCl given a drip in 30 - 40 minutes.
6) Heparin 20,000 units per 24 hours.
7) Monitor diathese hemorhagi after 2 hours, if not improve, add 2 flacon ABU again. ABU maximum given 300 cc (1 flacon = 10 cc).
8) If there are signs laryngospasme, bronchospasme, hypotension, urticaria or give adrenaline 0.5 mg IM, hidrokortisone 100 mg IV.
9) If necessary hemodialise.
10) If diathese hemorhagi improved transfusion components.
11) Observation of patients had at least 1 x 24 hours
Note: In case of anaphylactic shock due to ABU, ABU must be entered quickly with a given adrenaline.
e. Giving ABU
Management
a. Principle of handling the snake bite victims:
1) Block the absorption and spread of venom.
2) Neutralize can.
3) Treating complications.
b. First aid:
First aid, make sure the area around the safe and snakes have gone looking for medical help right away do not leave the victim. Next do rigt principles, namely:
R: Reassure: Reassure the victim, the victim calm and rest, panic will increase blood pressure and pulse so that the poison would spread more quickly into the body. Sometimes the patient fainted / panic because shocked.
I: Immobilisation: Do not move the victim, the victim instructed not to walk or run. If within 30 minutes of medical help does not come, do technique swathe press (pressure-immoblisation) in the area around the bite (hands or feet) refer to the process pressure immobilization (bandage press).
G: Get: Take the victim to a hospital as soon and as safely as possible.
Q: Tell the Doctor: Inform the doctor signs and symptoms that appear there were any casualties.
c. Pressure immobilization procedures (dressing press):
1) Balut press on the foot:
a) Rest (immobilisasikan) Victim.
b) Dry the bite wound.
c) Use an elastic bandage.
d) Keep the wound lower than the heart.
e) As soon as possible, do dressings from under the base of the toes upward.
f) Let your toes do not bandaged.
g) Do not remove the victim's pants or shirt.
h) Balut circular manner but not fast enough to block blood flow (viewable with a fixed color pink toes).
i) Give the board / pengalas hard throughout the leg.
2) Balut press on hand:
a) Balut of palms upward. (Fingers are not wrapped).
b) Wrap the elbow and arm bent 90 degrees position.
c) Continue wrapping the arm to the base of the arm.
d) Put the board as a fixation.
e) Use mitela to hold hands.
(Foruniverse, Nursing., 2010. Snake Bite First Aid, (Online), http://nursing foruniverse. Blogspot. Com/2010/01/pertolongan-pertama-pada-gigitan-ular_18.html, accessed July 17, 2011).
d. Management further
1) & rgin-bottom: .0001 pt; margin-bottom: 0cm; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent:-35.45pt; "> 5) ABU 2 flacon in NaCl given a drip in 30 - 40 minutes.
6) Heparin 20,000 units per 24 hours.
7) Monitor diathese hemorhagi after 2 hours, if not improve, add 2 flacon ABU again. ABU maximum given 300 cc (1 flacon = 10 cc).
8) If there are signs laryngospasme, bronchospasme, hypotension, urticaria or give adrenaline 0.5 mg IM, hidrokortisone 100 mg IV.
9) If necessary hemodialise.
10) If diathese hemorhagi improved transfusion components.
11) Observation of patients had at least 1 x 24 hours
Note: In case of anaphylactic shock due to ABU, ABU must be entered quickly with a given adrenaline.
e. Giving ABU
