@article{ref1,
title="Case report: safe tourniquet removal in Black Mamba (Dendroaspis polylepis) bites",
journal="American journal of tropical medicine and hygiene",
year="2021",
author="Pelle, Ratang Pholosho and Engelbrecht, Andreas and Lalloo, Vidya",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="The black mamba is known for its notorious potent neurotoxic venom. For this reason, their bites are often erroneously treated in the field with the application of a tourniquet in the hope of delaying systemic spread of the venom. Observational studies have shown that inappropriate tourniquet application is a common, harmful practice. An arterial tourniquet is not a recommended first aid measure because of the risk of limb ischemia and gangrene. When inappropriately applied, the rapid removal of the tourniquet in the emergency department may precipitate a life-threatening venom and metabolic toxin rush, leading to respiratory arrest. We present two cases of black mamba bites in Gauteng, South Africa, where gradual tourniquet removal was used to avoid a venom rush and rapid respiratory paralysis. Venom and metabolic toxin rush with potentially fatal respiratory muscle paralysis may be averted by gradual, cautious removal of field-applied tourniquets with concomitant antivenom administration.<p /> <p>Language: en</p>",
language="en",
issn="0002-9637",
doi="10.4269/ajtmh.21-0374",
url="http://dx.doi.org/10.4269/ajtmh.21-0374"
}