The snakebite

It was 6PM after another long day of surgery. Brent went with the resident to follow up on the cases in the ER when the resident non-chalantly says "snake bite....that one is us." The 14 year old boy lay still, as if in a trance, clearly favoring one arm. We found out this boy had been bitten three days ago by an extremely venomous snake in the ring finger. Attempts had been made by the 'traditional healers' to dispel the venom slowly moving its way up the child's arm. The 'healers' put several holes with needles in the boy's arm to no avail. Once the family gave up on the traditional route, they travelled apparently a great distance for a last ditch effort with Western medicine.

When we examined the patient's arm, it was full of dirt, needle holes, and so tense and swollen he barely had a pulse. He immediately needed IV fluid and antivenom. The ER had some generic "African snake bite antivenom" which we immediately pushed into his veins. He could barely move his arm due to the pressure building up in his left arm. In medical speak, this is known as "compartment syndrome" requiring an immediate "fasciotomy." In other words, we had to slice up his arm to relieve the pressure.

We called anesthesia to get ready to perform surgery. We got no response. A half hour later, we decided we were going it alone The medical students attempted to set up the equipment, replace IVs, and get ready for surgery. All the while, the patient was getting worse, much worse. He had virtually no blood pressure, had very little oxygen in his blood, and was dangerously anemic due to the hemolysis likely occuring secondary to the venom.

Courtney looked at the chart and sure enough he was O positive, the same blood type as herself. Courtney, being the fearless person she is, went to give blood without letting Brent or Dr. Brown know. Brent found her giving blood in a back room of the laboratory. He was in awe. There was no hesistation to giving blood in Africa. The child needed blood and Courtney gave it to him.

Anesthesia finally showed up and he eventually stabilized with Courtney's blood. We had saved his arm and his life.

-Brent Brown