better. If a specir.l suction "bulb having more pov;er thnn a breast p-ump 

 and with a smaller mouthpiece c^m be obtained, it will be found highly 

 efficient. In the absence of any such device, one may remove enough of 

 the venom by suction v/ith the mouth. It is best to be sure that there is 

 no abrasion in the mouth, for the venom is effective wherever it may enter 

 the blood stream. The principal thing to do is to use suction and remove 

 as much of the venom and as quickly as possible. If the above procedure 

 is followed within one hour after the bite, the chances are that no further 

 treatment will be necess,-\ry. It is always best, of course, to seek the 

 care of a com<petent physician as quickly as possible. 



While the cutting advised should go through the skin, care should 

 be taken not to cut too dee"nly nor to sever blood vessels of any size. If 

 inadvertently this is done, bleeding from veins, recognized by the dark red 

 color and steady flow, may be checked by a tourniquet placed on the far 

 side of the cut from the heart. Bleeding from an artery is bright red and 

 in spurts and may be controlled by placing the tourniquet between the wound 

 and the heart. In either case a knot in the tourniquet or a solid object 

 under it should be placed directly over the severed blood vessel. 



If you have antivenin with you, read carefully the directions for 

 preparing the syringe and making the injection. Do not allow fear or 

 agitation to make you overlook important points. When the syringe has been 

 made ready, proceed at once to inject the entire contents of the syringe 

 under the skin near the bite. The tourniquet should then be released for 

 a minute. 



Additional Treatment 



Additional treatment, or treatment in cases where the above methods 

 were not used soon after the bite, preferably to be administered by a surgeon, 

 should consist of follov^ing up the advance of the swollen area and making 

 a double row of incisions at the very upper edges *f the svv'ollen parts. 

 These should be about l/8 by 1/8 inch, and a series of them should completely 

 encircle the limb affected. 



It is well to remark here that novocain can be used by even a la^'- 

 man without ill effect. Besides enabling the one operating to do the 

 cutting without pa.in to the patient, it a.lso serves somewhat to check the 

 spread of the venom. It may be injected completely around the limb and 

 is very valuable in any emergency where a considerable amount of pain is 

 unavoidable in rendering first aid. 



As the swelling advances the one administering medical aid should 

 follow it up with the incisions, and should apply suction for a period of 

 at least thirty minutes to every series of incisions. In case one 

 particular region becomes more swollen than the others - a nest of incisions 

 should be made over and around it and suction applied there. If improvem.ent 

 is not shown the incision treatment should be repeated every four hours and 

 the suction kept up constantly, until relief is obtained. The punctures 

 will continue to leak diluted venom and bloody lymph for severrl hours. 

 The real danger lies in making an insufficient number of incisions rather 

 than too many. Should there be any doubt as to the number made, one should 



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