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#1
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09-26-2016, 06:57 PM
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 spiders in a people suit Poster Rank:13 Join Date: May 2015 Posts: 70,617 Mentioned: 241 Post(s) Quoted: 48195 Post(s)
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Puff Adder Bite
My first real post that doesn't have to do with spiders and isn't in the WC... A 13-year-old boy was presented to a hospital in the central african republic because of snakebite on his left hand that had occurred six hours before. He was hunting bush rats, and when he put put his hand in a hole, he was bitten. On arrival, he presented clinical hemorrhagic syndrome with gingival bleeding and an edema extending to his back and shoulder. Laboratory tests carried out included WBCT20 (whole blood clotting test, 20 minutes) and the patient had incoagulable blood. Just after his admission, he received the first dose of antivenin (FAV-Afrique®) in association with the usual non-specific treatment (tetanus toxoid, tetanus vaccination, amoxicillin, acetaminophen, and ibuprofen). Due to persistent swelling (the edema reached the thorax), he received a second dose of antivenin six hours after the first. Then the edema stopped increasing and there was no more clinical bleeding. Although the edema stopped growing, the hand still had a worrying aspect - the skin was very hard; nails were white, without any evidence of blood circulation; and physical examination showed sensory and movement deficits. The patient underwent surgery on Day 1. Perioperative observations showed hand compartment syndrome and deep hematomas. Fasciotomy was performed and muscles below were black with almost no blood flow. The patient went back to the operating room every 2 or 3 days in order to clean the wound and remove necrosis. The local evolution was unfavorable. Necrosis extended to the whole hand and finger amputations were necessary. The snake was identified as Bitis arietans, also known as the puff adder. B. arietans is responsible for causing the most snakebite fatalities in Africa because of its wide distribution, frequent occurrence in highly populated regions, potent venom that is produced in large amounts, long fangs, and their habit of basking by footpaths and sitting quietly when approached, and aggressive temperament. The species name is derived from the Latin word arieto, meaning "striking violently". The venom has cytotoxic effects and is one of the most toxic of any vipers based on LD50. Initial aspect of the left hand  Initial aspect of the left hand, second image  Fasciotomy  Necrosis aspect  Finger amputation and necrosis  Finger amputation and necrosis, second picture  Finger amputation and necrosis, third picture  Clean aspect of the hand, after eight surgeries  The range of Bitis arietans in Africa  A few pictures of B. arietans     |
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#6
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09-26-2016, 11:20 PM
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 My Rank: STAFF SERGEANT Poster Rank:729 Male Join Date: Nov 2011 Posts: 1,125 Mentioned: 0 Post(s) Quoted: 243 Post(s)
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Re: Puff Adder Bite
 Would have been easier to lop it off at the wrist in the beginning.
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#8
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09-26-2016, 11:26 PM
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 My Rank: LANCE CORPORAL Poster Rank:3437 I sit to pee if that helps Join Date: Aug 2015 Posts: 103 Mentioned: 0 Post(s) Quoted: 5 Post(s)
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Re: Puff Adder Bite
Holy shit! People need to stop trying to grab these poisonous snakes. Most bites to the hand are from trying to pick the snakes up.
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#10
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09-27-2016, 02:01 AM
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| My Rank: FIRST SERGEANT Poster Rank:422 Female Join Date: May 2013 Posts: 2,731 Mentioned: 13 Post(s) Quoted: 1093 Post(s)
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Re: Puff Adder Bite
He wasn't trying to grab the snake. He was sticking his hand in a hole, looking for rats. We don't have snakes that deadly around here, but are taught to NEVER stick your hands or face in an unknown/unchecked hole. Dang kid. |
