Sawyer venom extractor

[SCReptiles]

While at the Bristol venomous expo I had the great fortune to pick the brain of Jim Harrison of the Kentucky Reptile Zoo (http://www.geocities.com/kentuckyreptilezoo/) . For those that do not know him, he is one of the nation’s foremost experts on envemonation. He has been featured in countless television and print envenomation reports. Most of what I learned from Jim fell directly in line with what I already had researched and believed to be true, save two things. One was CroFab. My limited research lead me to believe it was a far superior medicine, but Jim has not been pleased with it since put into practical use. The second was Jim’s opinion on the Sawyer extractor. Jim does not believe in the use of the extractor at all. He feels holding the venom in a set location rather then allowing it to dilute within the body is more harmful. The added cell damage will out weight the benefit of the amounts of venom one can remove. I am interested to know everyone’s opinion on the extractor and any research one my have done or happened across. Thank you for your time.

[Matt]

i worked at the kentucky reptile zoo this past fall with Jim......so my thoughts on these topics have been influenced by Jim, so they could be condsidered biased. :)

first, IMO Crofab has not worked nearly as well as Wyeth did when it was still in production. it has proven to be not very useful on some key species....and it costs a hell of alot more, for a reason i cant understand

as for the extractor......
the sawyer extractor dosent work IMO. It wastes valuable time that should be spent getting to the hospital....however, if it calms the person down and relaxes them a bit....then that is a positive effect in itself. But the extractor does nothing to pull venom out of tissue. Its a myth that you suck venom from a bite, and the sawyer extractor is a product that exploits that myth.
once the venom has more than a couple seconds to penetrate, it has already gone into the tissue further than any suction could retrive it.....plus the venom disperses making it impossible to get it all (if but some miracle you even manage to get any).

while I worked with Jim, we had a chance to discuss many envenomation cases and the extarctor has never been proven to work on any of them....and on top of that, it has wasted precious time before AV is administered

anyways, just my opinions, but i feel strongly about them

[reverendsterlin]

I never believed in extracors, just doesn't seem possible the they could ever extract enough venom from a bite deeper than the surface nor am I willing to do any tissue damage on myself, enough problems with that from the venom, still from what I remember reading it has been said that the application of a negative pressure extractor within 5 minutes of the bite can possibly remove up to 70% of the venom. As for Crofab, as far as I know it is about as effective as wyeth, is responsible for fewer allergic reations (ovine instead of equine, those allergic to sheep products may still be at risk), goes into solution faster, and is basically the only game in town. I have also heard that some studies on it's effects on other types of crotalus and agkistrodon envenomations have been positive.

[reverendsterlin]

the cost difference seems weird to me also Crofab's $850 a vial to Wyeth's $440, but supposedly a part the higher cost is offset by the need for fewer vials of Crofab compared to Wyeth(though I think it was Crofab 10-15 vials Wyeth 4-20 vials) with some claims that 2-4 vials of Crofab being effective in low envenomations. Just not enough indepth study on Crofab by people other than Protheric or researchers. they may have paid

[SCReptiles]

Jim grants that the CroFab is working well on most specimens. In fast I think he said it was doing better on the Mojave, however, he feels the CroFab is not effective at all on Timbers or Blacktails. He is very excited over a new medicine coming out of Mexico. I think it is called bioclone. The preliminary results are very promising and the cost is much less then CroFab. Thus far I have not been tagged by a venomous snake, but I was hit by an imported 5 foot Nile last year. Due to the possibility of bacteria infections that are associated with wild monitor bites I decided to extract the wound. I wasn’t sure if it would help, but thought it couldn’t hurt. I was very please with the results. The extractor filled the largest cup size with blood within a matter of seconds. I extracted about 3 or 4 times, then treated with antiseptic and no infection ever occurred. With the sheer amounts of blood the thing pulled, I have trouble believing it wouldn’t pull out the venom that was anywhere near the bite. Unless I misunderstood, I don’t think Jim ever said it wouldn’t pull out any venom, just that the negative of restraining the venom to that limited area would out weight the positives of the amounts of venom one could retrieve. I concur completely with Matt’s implication of not wasting time getting to the hospital. Prior speaking with Jim, my thoughts were to use it while waiting on an ambulance or while a third party gets a vehicle to drive the victim to the ER. Now, I am not so sure about even using it and I am very excited to hear other opinions on the extractor, and not so much the anti-venom. We are pretty much stuck with CroFab for now, so there are not any options to weight.

[Matt]

Originally posted by SCReptiles
Unless I misunderstood, I don’t think Jim ever said it wouldn’t pull out any venom, just that the negative of restraining the venom to that limited area would out weight the positives of the amounts of venom one could retrieve.

chuck, you could be right, Jim may have not said that it wouldnt suck ANY venom....thats just my opinion, maybe not his, Im not sure where he stands on that

as for the AV....Bioclon is available now from mexico and it is supposed to be good for all Crotalus as well as some other mexican pit vipers....cant recall off the top of my head hich spp. (I think some Bothrops), but i have it written somewhere
i think its going for as little as about $50-$75 per vial....not bad, sounds like a good alternative

[SCReptiles]

Yeah, I like that price. My state, TN, requires one to keep AV on hand in order to get a venomous permit. If ever I qualify, I will have to keep it on hand and $50 a veil sure sounds better then $900. =) I am not saying you are wrong, but what do you base your opinion on concerning the extractor not pulling any venom?

[BWSmith]

I teacht he use of the Extractor for one purpose, calming the victim. I teach the emergency personnel to show the victim the extractor (while in transit of course) and explain what it is "designed" to do. The apply it several inches below the bite site and often mearly holding it against the skin without applying the negative pressure. Does wonders for the uneducated ;)

[Matt]

Originally posted by SCReptiles
I am not saying you are wrong, but what do you base your opinion on concerning the extractor not pulling any venom?

like i said, this is only my opinion, but when envenomated, the venom disperses SO quickly. by the time one applies the extractor, i would think that most of the venom would no longer be in the immediate area of the bite.
now.....im not saying that ABSOLUTELY no venom would extract, you probably would get trace amounts....
but, i believe that because of the way venom disperses, the amount you would get is so neglegable.

...also, some venom attacks the lymph system, not the circulatory system.....it this case, pulling out a quart of blood isnt going to help at all

these are my opinions and to be quite frank, I dont have very much to base it on other than many readings and my working closely with Jim....but i still fell strongly