title: Ornament induced complications in snake bites: Revisiting the "Do it RIGHT" approach.
abstract: Limb adorning ornaments (LAO) can exacerbate the local effects of envenoming in case of venomous snake bite. Cultural presuppositions do inhibit victims from removing symbolically/ritually important jewelry even under circumstances that might increase the dangers of envenoming-induced gangrene formation. The recommendation to remove the LAO is usually skipped in guidelines and if at all included the very real hazard is uncommonly documented. We observed 14 cases of snake bite with LAO on the bitten limb with minimal to severe local complications. The possible reasons were discussed with recommendations of proper and timely methods of removal of these ornaments. We suggest inclusion of this concept of 'Remove' in the recommended first aid methods of the guidelines/protocols.
authors.affiliation: Department of Forest and Environment, Honorary Wildlife Warden, Government of Odisha, and Snake Helpline, Khordha, Odisha, India.
authors.forename: Subhendu
authors.initials: S
authors.lastname: Mallik
authors.affiliation: Department of Forensic Medicine and Toxicology, AIIMS, Bhubaneswar, Odisha, India.
authors.forename: Sudipta Ranjan
authors.initials: SR
authors.lastname: Singh
authors.affiliation: Department of Anesthesiology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India.
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Sahoo
authors.affiliation: Department of Forensic Medicine and Toxicology, AIIMS, Bhubaneswar, Odisha, India.
authors.forename: Manoj Kumar
authors.initials: MK
authors.lastname: Mohanty
keywords: First aid; gangrene; ornaments; protocol; snake bite