RISK
Although medevac may still ultimately be required,
the ability to assess and treat the wound locally offers
numerous benefits. First, the bite can be treated more
quickly without a delay in the time to transfer the patient.
This is proven to produce much better patient outcomes.
The knowledge that this service is at hand also presents
the workforce with greater peace of mind and can
improve morale. In addition, the company is also opening
an opportunity to provide supplementary support to
remote, local communities where, previously, the chances
of a good outcome following envenomation were low.
This enhances corporate social responsibility (CSR) and
generates goodwill in the local community.
downsides to this approach. First, a medevac is costly
and places stress on the evacuating patient. Second,
and more critically, time really is of the essence when
it comes to treating a snakebite. Delaying treatment
means increased damage to surrounding tissue, resulting
in greater risk of permanent disability or even a fatal
outcome. The progression of necrosis can be prevented
or stopped by antivenom administration, but once the
damage has been done it cannot be reversed. Another
question when considering the Medevac option is that,
once evacuated, does the medical centre the patient is
transferred to have the correct antivenom and expertise
to deal with the envenomation? There is still the need for
a complete care strategy.
Preventing snakebites is the best way to manage them. In picture is a
Rhino Viper.
In Kenya, snakebite envenoming claims thousands of lives
every year and, like diseases such as malaria, is a part of
everyday life. For the mining and oil and gas industries, the
threat of snakebites in this area is probably one of the top
three risks to workers.
To support its local strategy in dealing with snakebites,
International Oil Company Tullow Oil has worked
alongside RMI with the support of the Asclepius Snakebite
Foundation to put a robust response strategy in place for
its sites in Kenya. This includes donations of medicines, and
training of staff in local hospitals to systematically assess,
diagnose, and treat patients with snake envenomation.
The definitive treatment capability that has been
developed produces better patient outcomes for anyone
who is bitten in the area, and reports are already indicating
a reduction in snakebite deaths and disabilities and an
increase in patients seeking treatment in the area since the
programme began.
A robust response strategy
Close to 600 000 people are killed or permanently disabled through
snakebites each year. In picture is the venomous Egyptian Cobra.
According to Andy Kimmell, operations director, Global
Coordination & Security at RMI, a medical response team
for an envenomation needs to be trained specifically for
such an event but the overall management of snakes in
the area requires cooperation through a multidisciplinary
team. “We work with experts in snakebites and antivenom
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African Mining Publication
The response strategy from RMI includes evaluation
of the local threat, identification of species of concern,
assessment of the relative risk to workers, and a clear
risk reduction strategy. The clinical implementation
comprises assessment of which antivenom is most
effective against the local venomous snakes of medical
significance and the creation of advanced field treatment
protocols, along with continual advisement and 24/7
consultation with medical and subject matter experts
(SME) in the event of envenomation.
A thorough knowledge of the type of snakes that occur in the region of
operation is imperative for acting decisively when a snakebite happens.
The photo depicts a venomous Forest Cobra.
African Mining
African Mining April 2020
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