In the UK approximately 100 people are envenomated by a snake each year.
So what do you need to do if your patient has received a venomous bite from a snake? (not the classic UK cocktail).
- Don’t Cut & Suck!
- Treat what you see
- Call Toxbase
In the UK approximately 100 people are envenomated by a snake each year.
So what do you need to do if your patient has received a venomous bite from a snake? (not the classic UK cocktail).
We often worry about patients developing rhabdomyolysis and consequently developing AKI. However, there is much debate and little consistency in the published data, over how to diagnose and who needs admission to treat. So its important to consider both clinical context along with laboratory values
Preform intimate examinations on Sexual assault/Rape patients
Vascular surgery has been reconfigured across etc region. The vascular oncall will be based at BRI 24/7.
Multiple pathways have been developed below to help guide appropriate use – full guide HERE
Some patients benefit from control of bleeding using embolization techniques, which is a procedure performed by an Interventional Radiologist.
Patients should be treated in their receiving hospital to the maximum of that hospital’s capability, where at all possible. When all local treatment options have been exhausted, the patient should be discussed with one of the Arterial Centres (BRI) with a view to transfer for ongoing management by IR techniques.
Access is very limited to this clinic. It is envisioned by WYVas that access to UVAC for ED patients will be arranged through direct (telephone) referral to either:
Remember: is it a haemolysed blood sample? (you can do an iSTAT)
Severity
We frequently consent for Blood Transfusion, but what risks do we tell the patients about and how common are those risks?
In anybody who there is suspicion of a non-traumatic haemorrhage arrange an urgent CT Head.
All patients need IV access and U&E, FBC, Coag
If CT confirms PICH (not traumatic, not SAH): –
If anticoagulated with warfarin or NOAC discuss with stroke consultant and Haematologist regarding reversal
If not anticoagulated give Tranexamic acid – 1g in 100mls Saline/Glucose over 10 mins followed by 1g in 250mls Saline over 6 hours.
BP needs to be <150/80 – use labetalol (max 400mg – until BP <160 or HR <50) and GTN infusion
Not all patients with intracerebral bleeds need referral to neurosurgery – you could save yourself and your patient a lot of time and effort!
Those to refer:
Necrotising fasciitis (NF) is a rare but serious bacterial infection that affects the soft tissue and fascia (Fournier gangrene, is NF affecting the perineum). In many cases NF progresses rapidly and early recognition and treatment is vital to halt progress. The mainstay of treatment is IV antibiotics and aggressive surgical debridement. Any delay increased the amount of tissue loss as well as the mortality. Read more
For many conditions the patient should be informed to stop driving and inform the DVLA of their condition. It is the patients responsibility to inform the DVLA, and we should encourage them to do so.
[There is a £1000 fine AND the risk of prosecution] Read more