RECENT snake sightings ahead of the cooler change have revived discussions about how – and where – victims of snake bite in our area access help in an emergency.
About a month ago a local man was bitten by a small brown snake on the lawn of a property one hour’s drive out of Coonamble while “doing mouse pick up with bucket and tongs”, a common activity in recent months.
While not wanting to be named, the family say they “did all the right things” – avoiding movement, bandaging the bite site and extending the bandage up the limb – before heading in to Coonamble Multi Purpose Service.
After some time in Coonamble, and without any symptoms of poisoning. He was taken to Dubbo where he had blood taken every two hours and was kept overnight for observation.
“It only just left a ‘love bite’,” the man’s wife said. “He was fine, it was just a little warning.”
The incident has led to speculation that the necessary anti-venom was not available at the Coonamble MPS at the time.
“It’s not hard to be bitten,” said Coonamble grazier and seed grader Paul Underwood.
“If it’s more than a surface scratch, things can go seriously wrong pretty quickly and it’s a long way to Dubbo.”
Mr Underwood says he is concerned that anti-venom isn’t always on-hand at a nearby MPS.
“We just always assumed the anti-venom was there,” he said.
Inquiries by the Coonamble Times reveal that anti-venom is meant to be available at all the multi purpose health services in the area, although NSW Health have not been able to confirm availability at specific sites on specific dates.
Genevieve Adamo is a pharmacist at the NSW Poisons Information Centre (NSWPIC) which services the whole state on a 24/7 basis from their location at the Westmead Children’s Hospital.
“The Coonamble hospital does have anti-venom,” Ms Adamo told the Coonamble Times.
She says she has checked a statewide database and that Coonamble and surrounding small hospitals or multi purpose services are recommended to keep antivenom.
“What it stocks is determined by the venomous creatures in the area,” she said.
“There are NSW Snake and Spider bite clinical guidelines which include consulting a clinical toxicologist and the standard of care has not changed.
“The Clinical toxicologists are looking at information that is being updated constantly.”
The NSWPIC is part of the health response to any snake bite or suspected bite and Ms Adamo says that the most critical steps are the ones taken in the minutes after a bite and she would like to see more people in rural areas trained in First Aid.
“The most important thing is immediate First Aid – good, quick appropriate First Aid is what saves lives,” she said. “Every snake bite is a medical emergency – don’t walk, don’t drive, stay still and call an ambulance.”
“There can be an early cardiac collapse so the family, wife and even the kids need to know how to give immediate CPR (cardio pulmonary resuscitation).
Ms Adamo says calling the Ambulance is a vital first step, even if you think it would be quicker to drive to help.
“The 000 team will work with you through the whole process, they will tell you what to do and support that person,” she said.
“Anyone bitten needs to go to hospital and be assessed. If envenomed they will be given antivenom immediately in consultation with the toxicologist at the Poisons Information Centre.”
“Then decisions are made by the clinician about which facility can provide the best care,” Ms Adamo said.
She says there are risks associated with giving antivenom if it’s not needed, and patients can have anaphylactic shock even with the correct antivenom.
“There’s a lot to it that people don’t understand and it is likely a patient will be sent to Dubbo because of the level of care required,” she said. “It’s not unusual for people to be moved for blood tests but a hospital will move them while they’re stable so if anything goes wrong the right people are there to respond.”