View source for Pressure immobilization dressing

==Background==
*Type of field dressing developed and used in Australia primarily for elapid bites<ref>Robert L. Norris, Sean P. Bush, Michael D. Cardwell. Bites by Venomous Reptiles in the United States, Canada, and Mexico. Paul S. Auerbach. In: Auerbach’s Wilderness Medicine. 7th Ed. 2017: 742.</ref>
*Theoretic reduction in systemic toxicity<ref>Robert L. Norris, Sean P. Bush, Michael D. Cardwell. Bites by Venomous Reptiles in the United States, Canada, and Mexico. Paul S. Auerbach. In: Auerbach’s Wilderness Medicine. 7th Ed. 2017: 742.</ref>

==Indications<ref>David A. Warrell. Bites by Venomous and Nonvenomous Reptiles Worldwide. Paul S. Auerbach. In: Auerbach’s Wilderness Medicine. 7th Ed. 2017: 816-818.</ref>==
*Only useful in extremity bites
*Neurotoxic [[Elapidae (Coral Snakes)]] bite (mamba, king cobra, taipan, etc.)
*Sea snake bike
*[[Funnel-web spider bite]]
*Consider in: large snake size, particularly lethal species, prolonged fang contact, small patient size, prior exposure to venom

==Considerations Before Application==
*Not indicated in [[Crotaline (Pit Vipers)]] bites (ie. rattlesnake).
*Consider plan for extricating the patient
**Patient must be ''carried'' out of the field once dressing is in place
**The dressing must '''not''' be taken down ''until the patient has reached definitive care''. Removing the dressing may release a bolus of venom and antivenom should be immediately available.

==Technique==
*Place the extremity in a neutral position
*Use an elastic or crepe bandage to wrap the entire affected extremity (distal to proximal)
*Wrap very firmly, with the same pressure used to splint a sprain, but not so much as to obstruct distal pulses. 
*Continue to wrap the extremity to a rigid splint (ie. dowel) to immobilize. 
*Extricate the patient
[[File:Pressure immobilization.png|thumb|Australian Pressure Immobilization Technique<ref>Robert L. Norris, Sean P. Bush, Michael D. Cardwell. Bites by Venomous Reptiles in the United States, Canada, and Mexico. Paul S. Auerbach. In: Auerbach’s Wilderness Medicine. 7th Ed. 2017: 742.</ref>]]

==Limitations==
*Insufficient pressure applied by provider
*Challenging to self-administer
*Contraindication to self-extricate once applied
*Contraindication to remove until antivenom available
*Inadequate study in use of necrotic [[Crotaline (Pit Vipers)]] envenomations. Contraindicated at this time.

==See Also==
*[[Snake Bites]]
*[[Funnel-web spider bite]]

==References==
<references/>

[[Category:Environmental]]
[[Category:Procedures]]