Sorry Drongo, I must disagree strongly with some of your assertions. While I agree that over 95% of snakebites will not be fatal, they are by no means uncommon, with an incidence of 30-80 hospital admissions per 100,000 population per annum in SA. Note admissions - many more don't present to hospital, many are not admitted and a number die before making it to hospital. You do not have hours with Mamba envenomations. You may have minutes, especially where your circulation is rapid as in cycling. I quote the example of Colin van Heerden who was bitten during the 2002 Dusi marathon, and was incapacitated within minutes. Pressure bandaging is ineffective for Mamba envenomations - the venom is too rapidly absorbed. Pressure bandaging has not been shown to be effective for South African snakebites, except possibly for non-spitting cobra bites where venom is transported via lymphatics. Most of the research on pressure dressings was done in Australia, where venoms are different to SA. However Australian research has shown that correct application of a pressure bandage is the exception rather than the norm, even in trained individuals. A tourniquet is ABSOLUTELY contraindicated in cytotoxic envenomations. A tourniqet can be left on for 90 minutes without risk of tissue ischaemia. It should not be released every 30 minutes as that would defeat the object of the exercise and allow circulation of venom to the rest of the body. We are talking about an arterial tourniquet here - it must be tight enough to stop circulation into the limb (ie no pulse palpable). Use a broad belt or strap from a Camelbak etc. .
