Field trial of efficacy of local compression immobilization first-aid technique in Russell's viper (Daboia russelii siamensis) bite patients.

A field trial of efficacy of local compression immobilization first-aid technique in 42 Russell's viper bite cases was studied and only 19 were envenomed. Proper immobilization was carried out in 3/13 immobilized cases. The average time of application of the pad was 1.12 hours (range 5 minutes to 7 hours) and the total duration of the pad application was 3 hours 40 minutes (range 30 minutes to 9 hours). Venom levels measured at the hospital before and at 15 and 30 minutes after release of the pad (n=10) showed a rise of 5 to 30 ng/ml of venom following release. Movement of venom antigen was found to be retarded in all cases (n=9) whose venom levels were measured at 15 and 30 minutes with the pad in place. Sixteen out of 19 cases had systemic envenoming, indicating that pad or immobilization alone is not effective in delaying spread of venom. The incidence of local necrosis 3/42 (8%) following use of the pad was comparable to that of the systemic cases without the pad. No ill effects were observed following its application for as long as 9 hours. Local blackening seen in 4/36 (10%) cases was likely to be result of a local venom effect.