10-08-18 How do you elevate an extremity to decrease swelling following TN snake envenomation?

Toxicology Question of the Week

October 4, 2018

How do you elevate an extremity to decrease the swelling following TN snake envenomation?

We have had so many snakebites this year!!!

In this part of the country, one of the major morbidities of snake envenomation (primarily cottonmouth or copperhead) is the swelling.  Elevation will use gravity to drain the edema and is an essential part of the treatment-it may play a more important role in treating the swelling than Crofab.  Unfortunately, elevation on pillows is frequently considered adequate.  It is not.

When the envenomation is on a hand, finger traps are just too painful-don’t use these.  And unless the arm/hand is small, stockinette is also too tight and painful. 

I’ve attached a picture demonstrating elevation using an ace tied to an IV pole (essentially making a sling) to elevate the hand. You can then use some soft wrap to keep the hand in the sling   Obviously, you can use the same approach for the leg. 

Did you know…

We recently moved from Oxford House to Crystal Terrace on 3319 West End Ave (one of the reasons the Question of the week was delayed).  Our Poison Center Hotline is now so updated that you will think you are in the USS Enterprise or the Millennium Falcon.   Please come and take a look-we’ll be glad to show you around.

I am interested in any questions you would like answered in the Question of the Week.  Please email me with any suggestion at donna.seger@vanderbilt.edu

Donna Seger, MD

Medical Director

Tennessee Poison Center

www.tnpoisoncenter.org

Poison Help Hotline: 1-800-222-1222

The Question of the Week is available on our website: www.tnpoisoncenter.org