The Medical journal of Australia
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Case Reports Comparative Study
First-aid for snake-bite: efficacy of a constrictive bandage with limb immobilization in the management of human envenomation.
A herpetologist was bitten on the thumb by a common brown snake (Pseudonaja textilis). A constrictive bandage to impede lymphatic and capillary flow was applied, and the upper limb was immobilized. Two hours after the bite, there were no signs of symptoms of envenomation and venom (to a sensitivity of 0.5 ng/mL) was undetectable in serum and urine. ⋯ No anaphylaxis of other allergic phenomena occurred, despite the fact that three other doses of antivenom had been administered in the preceding 36 months for prior elapid envenomation. By means of an experimental whole-mouse technique, and an enzyme-linked immunospecific assay (ELISA) system, the snake involved was shown to deliver 4.91 mg of venom in an average bite. A constrictive bandage properly applied to impede lymphatic and capillary flow, together with limb immobilization, is effective in the field management of human elapid envenomation.
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Placenta praevia accreta is a rare life-threatening complication of pregnancy. Four cases are presented from one hospital over a period of 10 years in which there were 36 608 deliveries, an incidence of one in 9152 (0.011%). In all cases there was a successful outcome for both mother and baby, despite different forms of management.