Pressure Bandage for Australian Snake Bite

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The application of pressure bandage, combined with immobilisation of the bitten limb, has been the standard of care for Australian snake bite since the studies by Straun Sutherland. The technique was shown to slow the systemic absorption of an analogue of the venom of the elapid family of snakes native to Australia by cessation of lymphatic flow carrying the venom from the affected limb. A recent systematic review by Bert Avau and others has recommended against the use of the pressure bandage for 2 main reasons: First that the venom of the crotalid family of snakes (found in many countries) has a different mechanism of action resulting in increased necrosis at the bite site and second because studies have demonstrated that lay application of pressure bandages exerts too little pressure to stop lymphatic flow. Avau et al cite multiple papers disputing the efficacy of the technique or the ability of first aiders to apply sufficient pressure.. The current study aimed to determine if experienced first aiders are able to apply sufficient pressure to stop lymphatic flow (estimated to be 40 - 70 mmHg for the upper limb and 55 – 70 mmHg for the lower limb)

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