RISK
Prevention of snakebites is the first goal. The team works
proactively with snake handlers, safety and security teams
to try to remove the threat of snakebites from camps
and work areas. Inevitably, however, this cannot be 100%
assured and snakebites do occur. When this happens the
circumstances are reviewed, and safeguarding procedures
updated if appropriate.
and a senior SME is always available to oversee incidents. It is
through a well thought out, robust and cohesive strategy, put
together by experts in this area, that we are able to save lives
and limbs.”
Safe and sound asleep?
“At a remote oil and gas camp in Kenya, a man sleeping in an
eight-man dormitory awoke with breathing difficulties and a
pain in his hand. The on-site medics quickly identified it as a
cobra envenomation and acted accordingly,” recalls Kimmell.
He adds, “Of course, a top priority was to administer the
correct antivenom and treat the patient. The neurotoxic bite
was attacking the respiratory system and quick action was
needed to save the man’s life. The other priority was to get the
other seven men out of the tent and to safety until the snake
had been found. Snake handlers and security teams worked
quickly to find the snake, humanely capture it and release it in
accordance with procedures outside of the camp.
The other underlying issue for this attack, however, was that
the snake entered a place that workers considered a place of
rest and safety. The onsite snakebite team, including handlers,
security and medical staff, worked to restore confidence
among the workers and carry out due diligence to ensure
there was not a bigger, unseen issue on site such as nest of
cobra eggs nearby that had gone unnoticed.”
“This example shows the complexity of dealing with
snakebites in an austere environment,” says Jordan Benjamin,
founder and executive director of the Asclepius Snakebite
Foundation. Every snakebite is a unique toxicological
emergency that must be dealt with quickly and precisely in
order to ensure the best possible outcome for the patient.
Every minute wasted after a bite occurs allows more time
for the various venom components to attack their targets in
the victim’s body, and there is a marked increase in mortality
for every hour that passes until the right dose of the right
antivenom is administered.
Invest in snakebite management plans
Companies that rely on medevacs as their primary response
to a snakebite fail to realise that they are making the
situation worse. It is far more effective, both in cost and in
outcomes, to invest in a robust snakebite management plan
with onsite antivenom treatment capabilities. A snakebite
is an occupational hazard, and the psychological effect
on others in the work area can also be significant. Robust
systems need to be in place to both react to the immediate
threat to life from the envenomation and deal with how
and why the bite occurred, taking any actions necessary to
reduce risk in the future.”
Developments in antivenoms have helped to reduce mortality
rates from snakebites in remote areas. Treatments were
previously based on using antibodies from horse serum and
required constant refrigeration. This posed several problems:
Antibodies from horse serum are known to produce high rates
of anaphylaxis and can provoke life-threatening anaphylactic
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reactions to the antivenom. Its administration required at least
two advanced medics on site to deal with any reaction. Since
95% of bites occur in rural areas of the developing world,
the need for refrigeration also severely limited where the
antivenom could be stored, often leading to a delay in getting
the antivenom to the patient.
Modern antivenoms are much more stable and use highly
purified antibody fragments that have undergone additional
processing to remove the immunogenic component of the
molecule responsible for severe allergic reactions. This means
they can be transported without cold chain refrigeration,
stored on a shelf at ambient tropical temperatures for years,
and administered safely by direct intravenous push, helping
reduce the time to treatment in remote locations.
“The advances made in antivenoms have helped enormously
with the threat to life of snakebites in remote areas. Freeze
dried serums that do not require refrigeration and have a
longer shelf life make treatment more accessible and more
affordable, as well as providing improved safety with lower
risks of an allergic reaction. With these antivenoms available,
more work now needs to be done in terms of outreach and
education to help remote communities deal with this threat,”
adds Benjamin.
Snakebites claim hundreds of thousands of lives and limbs
every year worldwide. A robust strategy to deal with an
envenomation is needed to reduce mortality rates and the
chances of permanent disability in the oil industry. By working
with subject matter experts and producing a complete plan to
reduce the risk of snake encounters and procedures to swiftly
and effectively treat snakebites at the point of injury when
they occur, RMI has helped the oil and mining industry better
handle this threat. Medevacs, although sometimes necessary,
should not be the primary approach to care of snakebites.
Through education and outreach, the industry can also deliver
vital support to local communities and workers to help make
lives safer and better in regions where they are operating.
African Mining
African Mining April 2020
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