Management of venomous bites and stings in British Military Personnel deployed in Iraq, Afghanistan and Cyprus.

Introduction

Snake and spider bites and scorpion stings are rare among British Military Personnelthough cases have been reported in soldiers from other countries. However, in certain areas of the world, they are common causes of death and severe morbidity in the local population. It is important that specific and simple guidelines are available for the management of military patients deployed overseas in Iraq, Afghanistan and Cyprus. These guidelines aim to provide a

guide to the recognition of venomous species in these geographical areas and offer a plan for the management of a patient presenting with a bite or sting. Since it is difficult to distinguish venomous from non venomous species, unnecessary contact with snakes, scorpions or spiders should be avoided and patients bitten by any species should be assessed carefully. Emphasis will be placed on the management of bites and stings from the first aid given by the soldier on the ground to the management by hospital staff of a patient with signs of envenoming

Background

British Military Personnel are currently deployed to 80 countries worldwide Deployments vary in strength from single military personnel to full operational deployment to countries inhabited by venomous snakes, scorpions and spiders. Of these countries only 3 have a Role 2E/3 or greater facility for casualty evacuation (Iraq, Afghanistan and Cyprus). It is only at this level that antivenom should be administered to a casualty presenting with signs of envenoming. This paper focuses on the geographical distribution, clinical effects of envenoming and management of bites and stings by snakes, scorpions and spiders in these countries