None listed
Conditions
Brief summary
Each year over 100,000 people die of snake bite, some of whom are Australian. The current recommended first aid (applying a pressure bandage and immobilising the victim) can be very effective but this method of first aid is often not performed correctly. We are trying to identify simpler and more effective methods, and methods that might allow the victim to still walk to get help. The research will NOT use snakes or snakebites or snake venom! The aim is to measure how fast it takes for a simulated snake bite, “mock venom”, to reach the blood stream after an injection in the skin in the participants leg. comparisons will be made, on separate days, with different new methods of first aid (a pressure pad or a cold pack applied over the simulated bite site). A further aim will be to test to see if the pressure pad method still works when the participant walks slowly on a treadmill.
Interventions
For the baseline study a simulated snakebite will be performed by injecting the lower leg of the patient subcutaneously with 10MBq of technetium-99m antinomy sulphur colloid in a volume of 0.1ml.
After the administration of the radiotracer, the patient will undergo imaging on a gamma camera until tracer activity is evident in an inguinal lymph node. The time taken for this to occur will be recorded.
Following the inguinal node visualisation, the gamma camera will be positioned over the liver a
For the baseline study a simulated snakebite will be performed by injecting the lower leg of the patient subcutaneously with 10MBq of technetium-99m antinomy sulphur colloid in a volume of 0.1ml. After the administration of the radiotracer, the patient will undergo imaging on a gamma camera until tracer activity is evident in an inguinal lymph node. The time taken for this to occur will be recorded. Following the inguinal node visualisation, the gamma camera will be positioned over the liver and imaging will commence. The time taken for the tracer to be visualised in the liver will be recorded. This process will be repeated for the following interventions: * Application of a pressure pad to the simulated snake bite area immediately following the tracer injection. The pressure pad will comprise an approx 5cm square, 2cm high cube of gauze dressing. Pressure will be applied by a sphygmomanometer cuff using a pressure of 60mmHg. * Application of a pressure pad to the simulated snake bite area in the same manner as above but the gamma camera imaging will be interspersed with treadmill walking at 2 km/hour with no elevation. Each episode of walking will last 5 minutes followed by 5 minutes of gamma camera imaging. This will continue until tracer activity is seen in the inguinal nodes and liver. * Application of a cold pack to the simulated snake bite area immediately after the tracer injection. The cold pack will comprise of a waterproof bag containing crushed ice and mixed with water to maintain a skin temperature under the cold pack in the range of 2-7 degrees. The patients will undergo all four studies with each study occurring at least two days apart.
Sponsors
Dr Paul Thomas
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
18 years or older Able to give informed consent Willing to undergo injection of radiotracer and lymphoscintigraphy Willing to receive topical therapy on lower limbs Able to walk gently on a treadmill in 5 minute sessions every ten minutes until an exercise end point in reached
Exclusion criteria
Pregnancy Breast feeding History of lymphatic disease Lower limb vascular insufficiency (venous or arterial) Previous trauma or major surgery to the lower limb Skin at risk of injury from pressure pad or cold pack Peripheral sensory neuropathy Diabetes Mellitus Ankle oedema Allergy to radiotracer Severe osteoarthritis or any possible impairment to mobility Unable to give informed consent Institutionalised Prisoners Participants requiring interpreters or attendants, those with LOTE, cognitive impairment or highly dependent on medical care.
Outcome results
None listed