A Creature in the Emergency Room
It was around 10:00 in the morning in Emergency Room (ER) of RIPAS Hospital, when a male adult patient came in restless with a snake twisted around his left arm and the said man holding its head with his right hand. I was given the task of being the nurse in charge at the time.
The number of patients who were coming in at the ER Department that morning was about more or less one hundred, divided in the Out Patient Department section, the day ward section, trolley areas, dressing and suturing room and the resuscitation rooms. There were ER doctors, staff nurses, nursing attendants and other health care workers present at that time. Specific staff assignments were given to each areas as well as instructions of duties and responsibilities.
A Strange Visitor
Here comes the patient with a snake in his hands. At first, this caused some degree of chaos in the ER upon seeing the patient in great anxiety and being restless. The situation later was controlled after the initial interview. Most of the ER staff when they saw the patient, avoided coming near him, the instinct to avoid being bitten naturally taking over. Two male staff nurses approached the patient from a considerably safe distance. Under instructions, he was led to the vacant resuscitation room. After a quick visual, the creature twisted around the arm of the man was found to be a rattle snake, one of the most recognized-and undoubtedly one of the most venomous-snake species in the world.
History of the Case
The patient was sweeping in the yard of his home earlier that morning. While he was cleaning a small dark space under the house with a broom, he suddenly felt something coil around his arm like a tight rope. The patient immediately became restless due to the combination of numbness and fear. Asked if he was bitten, the patient replied that he did not know because his arm felt numb, but his reflexes were quick-and definitely lifesaving-by holding the rattlesnake’s head with his other free hand. Of interest is the fact that the man’s home is near a patch of forest. He was alone at home at the time of the incident-the nearest neighboring house was a hundred meters away.
Method of Approach
After taking the complete history of the patient, the ER physician’s first order was to observe the patient. Naturally, the vital signs could not be taken due to the delicate and potentially dangerous situation. The patient was notably pale and weak-looking. The ER staff brainstormed on possible ways to remove the snake from the man’s arm. The first method that came to the minds of many was to kill the poisonous reptile. Another was suggested by an old bystander who happened to hear of the discussion-he suggested administration of honey. However, no honey was found within the entire hospital premises. A third way suggested was to give 50% dextrose. Most of the staff agreed to the last technique. For the first attempt, the staff gave the 10-mL of the 50% dextrose solution to the snake via a 10-mL syringe; the solution was administered into the reptile’s mouth by drops. After some minutes, the reptile gradually weakened its hold on the man’s arm and it eventually fell off and onto the floor.
The staff immediately attended to the patient and placed on bed for monitoring. The attendant was then given instructions to take the snake immediately and place it on a closed basket with holes for examination.