Herpetologist Details His Envenomation and Death

Death by science.
thegrimsleepersays...

I don't like the speculation at the end. I don't feel it fits with the rest of the video. The diary and the autopsy report are cold, hard and scientific and listening to them made me feel kind of uneasy and in awe but the narration at the end made me just feel icky.

worthwordssays...

Note that in the absence of antivenom, DIC and respiratory suppression can be managed in an Intensive care setting - blood transfusions and fresh plasma for coagulation deficiencies would have been available at this time so it would have bene worth a try. I doubt that he underestimated the venom - bleeding from the gums is a clear sign of systemic coagulopathy which was not going to clear by itself and any herpetologist worth his salt would know that.

nocksays...

DIC is extremely tricky to treat and he would likely have died either way. The only consensus guidelines are to treat the underlying cause, which in his case was antivenin. Treatment with platelet transfusions and FFP are recommended only in certain circumstances (such as emergent surgery) and even this recommendation is without strong supporting evidence for its efficacy. Added FFP and platelets without treating the underlying cause can exacerbate end organ thrombosis. This thrombosis may be treated paradoxically with heparin.

worthwordssaid:

Note that in the absence of antivenom, DIC and respiratory suppression can be managed in an Intensive care setting - blood transfusions and fresh plasma for coagulation deficiencies would have been available at this time so it would have bene worth a try. I doubt that he underestimated the venom - bleeding from the gums is a clear sign of systemic coagulopathy which was not going to clear by itself and any herpetologist worth his salt would know that.

worthwordssays...

Agreed that DIC is hard to treat and there are controversies in management. I guess my point was that there were options available at that time in history which would have given him the best chance. Personally I would get the next flight to johanesburg.

nocksaid:

DIC is extremely tricky to treat and he would likely have died either way. The only consensus guidelines are to treat the underlying cause, which in his case was antivenin. Treatment with platelet transfusions and FFP are recommended only in certain circumstances (such as emergent surgery) and even this recommendation is without strong supporting evidence for its efficacy. Added FFP and platelets without treating the underlying cause can exacerbate end organ thrombosis. This thrombosis may be treated paradoxically with heparin.

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