TY  - JOUR
PY  - 2021//
TI  - Case report: safe tourniquet removal in Black Mamba (Dendroaspis polylepis) bites
JO  - American journal of tropical medicine and hygiene
A1  - Pelle, Ratang Pholosho
A1  - Engelbrecht, Andreas
A1  - Lalloo, Vidya
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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>
LA  - en
SN  - 0002-9637
UR  - http://dx.doi.org/10.4269/ajtmh.21-0374
ID  - ref1
ER  -