Health: Emergencies

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Edition 27: Spring 2004 Most common emergencies in the African bush can be easily averted by taking some straightforward and sensible precautions. Dr Richard Dawood has advice for staying safe on safari. Snakebite Find out about the local snake population before venturing into the wilds. Although it is not necessary to carry anti-venom, it is wise to know where the nearest medical care is available should you need it in an emergency. Avoid contact with snakes, and never attempt to handle them - even if they appear harmless or dead. Remember that snakes will usually only strike a moving object, so if you do surprise one keep perfectly still and wait for it to relax before slowly backing away. Wear good boots, especially when walking in deep undergrowth, and never poke your hands under rocks or in burrows or crevices. Lightning strike We often think of being struck by lightning as an extremely rare occurrence, but in the United States alone estimates of the annual death toll range from 70 to 400. In much of West and Central Africa there are as many as 200 thunderstorm days per year, and rescue services may be very limited in remote areas. If you are caught outdoors during a storm it's wise to stay clear of trees, water and objects such as fishing rods, metal umbrellas, metal jewellery and golf clubs, which can act as lightning rods. Tents and open vehicles provide no protection. In the event of a lightning strike first aid priorities include maintaining the airway and performing CPR. While many victims do need expert hospital care, some suffer only temporary paralysis of their breathing mechanism and may make a full recovery. Vehicle accidents Vehicle accidents are by far the largest cause of injuries to travellers abroad. In the bush, don't imagine the risks disappear because there are fewer vehicles to collide with - many accidents are due to loss of control. Observe strict safety measures, wear seat belts, drive cautiously and defensively. Don't go too fast on loose or rough terrain. Make sure that any vehicle you use is properly maintained, and that you have adequate supplies of fuel and water. Carry a good first aid kit. Ensure someone knows of your plans and can raise the alarm if you fail to make it back to base by an agreed time. Make sure you can raise help by radio, cell phone, or satellite phone in the event of an emergency. Just what if... In the event of a snakebite, Professor David Warrell advises the following response: 1. Reassure the patient. 2. Immobilize the bitten limb with a splint or sling. 3. Move the patient to a hospital or dispensary as quickly as possible. 4. Avoid harmful actions such as incisions, suction, potassium permanganate crystals, electric shocks and tourniquets. 5. If the patient has definitely been bitten by a dangerously neurotoxic species (such as a cobra or mamba) use pressure-immobilisation by applying a firm crepe or elasticated bandage (not a tourniquet) to the entire limb. 6. Use paracetamol, codeine or dihydrocodeine, not aspirin, to treat pain. 7. Do not attempt to pursue or kill the snake, but if it has been killed take it with you to the hospital, but do not handle it with bare hands.

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