Talk:Snakebite

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This is the talk page for discussing improvements to the Snakebite article.
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Snakebite was a good article, but it has been removed from the list. There are suggestions below for improving the article to meet the good article criteria. Once these are addressed, the article can be renominated. Editors may also seek a reassessment of the decision if they believe there was a mistake.

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To-do list for Snakebite: edit · history · watch · refresh
  • Some of the article is written in an informal tone with colloqual prose.
  • Needs a thorough copyedit. Plurals do not have apostrophes.
  • There is a good amount of material here on the medical side of things, but the article needs some background. There is nothing about the biology of snakes or the chemistry of their venom, perhaps there could be a few summary style paragraphs of snake venom or some such. Also mention the evolution of snake bites, and their general use for hunting and protection, not just from a human point of view.
  • The introduction should be two to four paragraphs long, summarising the article.
  • More images would be good, e.g. of a snake showing its fangs.
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I am delisting this as a good article, for the reasons in the to-do list above. If the article failed only one of those criteria I would not delist it, but I feel the prose/SP&G problems and a significant aspect of the topic being missing are major enough problems. Joe D (t) 05:18, 16 April 2006 (UTC)

Contents

[edit] Venom Immobilization

What is the problem with a tourniquet or with ice? Shouldn't a tourniquet be a better immbilizer than an elastic bandage? Icek 00:41, 19 April 2006 (UTC)

A tourniquet can localize the venom, and cause more harm than good by aggrivating swelling and necrosis, and studies have shown that often they're not applied properly or they're left on for too long resulting in ischaemia.[1] Ice also does not slow the spread of the venom through the system, and has been shown to have similar effects to an improperly applied tourniquet, including increased necrosis.[2] When I first started working with venomous snakes every professional told me that your best possible treatment is a spare set of car keys next to the phone, so you can call for help and/or be driven to the hospital immediately. -Dawson 02:57, 19 April 2006 (UTC)
'Application of ice. The process of chilling the wound area or the affected limb should certainly be avoided. This procedure would have the effect of slowing the blood flow to the area, thus preventing the natural dissipation of the venom and likely increasing its damaging effects.' This is misleading; while allowing the venom to dissipate is commonly-given advice when dealing with most US species, containment is generally preferred when dealing with elapid bites (cobras, coral snakes, most Australian species). I haven't seen ice advocated as a way of dealing with these, but the article should be careful not to present US-specific information as more general than it is. --Calair 23:41, 26 January 2007 (UTC)

[edit] Pressure immobilization uncertainty

Just how much pressure needs to be used is unclear. Everyone cites a 1994 study (I.M. Whyte. "Lymphatic flow rates and first-aid in simulated peripheral snake or spider envenomation.". Med J Aust. 161 (11-12): 695-700. ISSN 0025-729X. ) that claims that a fairly narrow (and high) range of pressures is required. Another study (Giles Hooker, PhD. "Physicians and Lay People Are Unable to Apply Pressure Immobilization Properly in a Simulated Snakebite Scenario". Wilderness and Environmental Medicine 16 (1): 16–21. ) claims that people are unable to achieve these pressures following written instructions.

However, other authors (Stuart Gray, Mcsp, B App Sc (Phty), Grad Dip Sports Physiotherapy, Grad Dip Recreation, Grad Dip App Sc (Outdoor Pursuits). "Pressure Immobilization of Snakebite". Wilderness and Environmental Medicine 14 (1): 73–73. ) claim that, with proper immobilization, the need for any external pressure at all is unclear.

Certainly (sorry, no citation handy) it's widely observed to be highly effective in practice, which the first two articles say isn't to be expected. I'm doing some research to try to understand this issue better. 192.35.100.1 17:28, 25 June 2006 (UTC)

[edit] Inconsistancies

The article says this: Approximately 85% of the natural snakebites occur below the victims' knees And then in the next paragraph this: approximately 65% of snakebites occur to the victims’ hands or fingers One of them has to be wrong.

Why not simply remove both numbers? topace10 14:34, 17 December 2006 (UTC)

I see nothing wrong with the statement. The first percentage refers to natural snakebites, while the second applies only to pet owners and people trying to capture snakes. No reason to change anything. --Jwinius 15:56, 17 December 2006 (UTC)

While it should be better worded, I can say with certainty that there is no contradiction (I authored much of the article). What is Jwinius is saying is true.--Mad Max 06:21, 15 January 2007 (UTC)

[edit] Immune System

I want to ask this question for every possivble "bite" or "sting" from an animal. Exactly why is it that the immune system is unable to eradicate the threat from the venom of whatever creature it was that injected the venom?

That's not completely true. It's possible to build up immunity against poisons like snake venoms by regularly injecting yourself with venom, starting with very small doses and building that up over time. Bill Haast is a famous example. However, when you stop the regular injections, the immunity begins to disappear. The venom vs. immune systems battle has been going on for many millions of years in an evolutionary arms race with natural selection always favoring venoms that are stronger than most of the immune systems around them. The immune systems are always playing catch-up. --Jwinius 12:20, 18 November 2006 (UTC)

[edit] Snake Stones

Hi, I'm looking for help on the Snake-Stones article. Desipte the advice given here against using black stone to treat a snake bite, it seems like it's still a widely used treatment promoted by state health care, charities and the International Labour Organization. One medical study found benefits in using black stone.

If you can help with the medical aspects or the article in general (it's the first that I've made major edits to) then I'd be very grateful. I'm monitoring Talk:Snake-Stones regularly. Thanks, Hamster128 10:45, 8 March 2007 (UTC)

[edit] Unclear fottnote in "Global evaluation of snakebite" table

The "Global evaluation of snakebite" table has a footnote that says "Population at risk". This footnote is rather vague. Which population - snakes or people? At risk in what way? --B.d.mills 22:46, 10 March 2007 (UTC)

I added an important elaboration about suctioning, as it is worth noting that the study referenced demonstrated that suction did not prove efficient when used 3 minutes after a bite occurence, but it would be interesting to see the same study done with the suctioning occuring at much faster intervals to look at its effectiveness.Wikismart 05:28, 7 May 2007 (UTC)

[edit] =

[edit] Suction Study Methodology Recommendations

Regarding suctioning by the use of pumps, it is true that several organizations have updated the snake bite treatment to exclude suctioning based on the results of the one study, cited below and in the references to the main article. There is no reference provided to support the statement that suctioning may cause harm or accelerate or facilitate the spread of venom. That sentence should be referenced. Wikismart is on the mark when wondering what happens within three minutes, as many first aiders assume that the suctioning is effective under three minutes, while that remains unverified.

On the other hand, the experiment was a simulation in a controlled environment, and not a representation of the real life performance of the Sawyer pump extracting venom. Where is the scholarly discussion about in what sense is saline solution with albumin, used in the experiment, similar in chemical and physical properties to the actual snake venom? A mere difference in density or flowability might explain the results. What if the chemical properties of the complex organic compounds known to be present in venom cause the venom to be much slower in spreading (than the mock venom)? What if the venom's compounds were of such a nature as to be much more easily withdrawn through pneumatic action?

Finally, to change the "modus operandi", the treatment algorithm for snake bite because of the results of one study, which appears to date not to have been reproduced, is not good practice, unless there were clear and convincing evidence of injury from the practice. What if after the published results regarding cold fusion, everybody in the world canceled their electric service in expectation of unlimited nearly free energy? Of course the results were not reproduced. In this case, we have one experiment which is being interpreted to mean far beyond what it actually proved: very little.

At risk of being attacked, I recommend trial of actual venom in animal subject of proven human-like physiology, such as small mammals. The trials need not be fatal. In this way, the effectiveness of suction devices could be compared nearly "apples to apples." 74.165.119.53 17:06, 28 June 2007 (UTC) ^ Alberts M, Shalit M, LoGalbo F (2004). "Suction for venomous snakebite: a study of "mock venom" extraction in a human model". Ann Emerg Med 43 (2): 181-6. PMID 14747805.

Alas, learning never ends... Apparently such research has been conducted with actual venom and survival rates following suction, see for example: http://www.llu.edu/llu/grad/natsci/hayes/research-b-snakebite.html

It seems the original article could improve by providing more complete references. 74.165.119.53

[edit] Tautology

Wow... that's quite the tautological first sentence... "A snakebite, or snake bite, is a bite inflicted by a snake." O RLY! --Hyperbole 08:37, 23 August 2007 (UTC)

[edit] Need for a section on medical treatment

I am amazed to find an article on snakebite with many lines about outmoded treatment and first aid but without even a single mention of antivenom. Obviously a person needs to know what is possible and available. AshLin 19:31, 21 September 2007 (UTC)

Regarding the medical treatment, it seems that sections of the article contradict itself when refering to treatment. Major copy edit, and more cohesive section on medical treatment is needed. 75.67.92.148 (talk) 07:51, 24 January 2008 (UTC)

Well, the entire first aid section should probably be rewritten due to WP:NOTGUIDE, but the problem is more of format than anything else. The fact that antivenom exists really should only cover a sentence or two. 130.64.73.98 (talk) 23:21, 21 April 2008 (UTC)

I think someone should address the common practice of using high voltage direct current (hvdc) treatment on snake bites. This is usually done with low voltage stun guns (25-50kv). There is a lot of information out there about the use of stun guns, or even spark plugs on a combustion engine, on the site of a snake bite to greatly reduce anaphylaxis. Ordosingularis (talk) 00:40, 6 May 2008 (UTC)