Abstract

In previous studies in Nepal, snakebite victims were found to either not have Pressure Immobilization Bandaging (PIB) or Local Compression Pad Immobilization (LCPI) performed for first aid, or had it performed incorrectly. The goal of this study was to evaluate training texts regarding first aid measures for snakebite and the rates of performance of both methods currently recommended, as well as ineffective or harmful practices. The study was conducted from September, 2009 to November, 2010. It evaluated the venomous snakebite first aid measures recommended in the 31 most recently published and commonly used Nepalese reference works and textbooks aimed at paramedical personnel, primary health care workers, medical undergraduates, and students of class five to bachelor´s degree. It compared the suggestions of these with those of published guidelines for the management of snakebite envenomation. Up to 100% of first aid measures advocated in these materials differed significantly from published guidelines. This included the omission of appropriate activities, misstatements and prescription of inappropriate treatments. Among appropriate recommendations that were missing was the advice to apply PIB or LCPI, and the suggestion to go to a snakebite treatment center. Fifty-five percent of the references did recommend emergency transport. Inclusion of accurate evidence-based information regarding first aid measures for venomous snakebite in commonly used texts could help to reduce the application of ineffective or harmful pre-hospital practices, their associated morbidity and mortality, and increase the use of appropriate methods.

Key words: Envenomation, snakebite, pressure immobilization bandaging, local compression pad immobilization, curriculum, health education.