Thailand - Understand & Survival (Chapter)

HEALTH

TRAVELLING WITH CHILDREN

85 species of venomous

snakes in Thailand. Always

wear boots and long pants if

walking in an area that may

have snakes. First aid in the

event of a snake bite involves

‘pressure immobilisation’ us-

ing an elastic bandage fi rmly

wrapped around the aff ected

limb, starting at the hand

or foot (depending on the

limb bitten) and working up

towards the chest. The band-

age should not be so tight

that the circulation is cut

off , and the fi ngers or toes

should be kept free so the

circulation can be checked.

Immobilise the limb with a

splint and carry the victim to

medical attention. It is very

important that the victim

stays immobile. Do not use

tourniquets or try to suck the

venom out.

The Thai Red Cross pro-

duces antivenom for many

of the poisonous snakes in

Thailand.

Sunburn

Even on a cloudy day sun-

burn can occur rapidly. Use

a strong sunscreen (at least

factor 30), making sure to

reapply after a swim, and

always wear a wide-brimmed

hat and sunglasses outdoors.

Avoid lying in the sun when

the sun is at its highest in the

sky (10am to 2pm). If you

become sunburnt stay out of

the sun until you have recov-

ered, apply cool compresses

and take painkillers for the

discomfort. One per cent hy-

drocortisone cream applied

twice daily is also helpful.

Travelling With

Children

Thailand is relatively safe for

children from a health point

of view. It is wise to consult

a doctor who specialises

in travel medicine prior to

travel to ensure your child

is appropriately prepared.

A medical kit designed spe-

cifi cally for children includes

paracetamol or Tylenol syrup

for fevers, an antihistamine,

itch cream, fi rst-aid supplies,

nappy-rash treatment, sun-

screen and insect repellent.

It is a good idea to carry a

general antibiotic (best used

under medical supervision) –

Azithromycin is an ideal

paediatric formula used to

treat bacterial diarrhoea, as

well as ear, chest and throat

infections.

Good resources are the

Lonely Planet publication

Travel with Children, and for

those spending longer away

Jane Wilson-Howarth’s book

Your Child’s Health Abroad is

excellent.

Wom e n’s He a l t h

Pregnant women should

receive specialised advice

before travelling. The ideal

time to travel is in the second

trimester (16 and 28 weeks),

when pregnancy-related

risks are at their lowest.

JELLYFISH STINGS

Box jellyfi sh stings range from minor to deadly. A good

rule of thumb, however, is to presume a box jelly is dan-

gerous until proven otherwise. There are two main types

of box jellyfi sh – multitentacled and single-tentacled.

Multitentacled box jellyfi sh are present in Thai waters –

these are potentially the most dangerous and a severe

envenomation can kill an adult within two minutes. They

are generally found on sandy beaches near river mouths

and mangroves during the warmer months.

There are many types of single-tentacled box jellyfi sh,

some of which can cause severe symptoms known as

the Irukandji syndrome. The initial sting can seem minor;

however severe symptoms such as back pain, nausea,

vomiting, sweating, diffi culty breathing and a feeling of

impending doom can develop between fi ve and 40 min-

utes later. There has been the occasional death reported

from this syndrome as a result of high blood pressure

causing strokes or heart attacks.

There are many other jellyfi sh in Thailand that cause

irritating stings but no serious eff ects. The only way to

prevent these stings is to wear protective clothing, which

provides a barrier between human skin and the jellyfi sh.

First Aid for Severe Stings

For severe life-threatening envenomations the fi rst

priority is keeping the person alive. Stay with the per-

son, send someone to call for medical help, and start

immediate CPR if they are unconscious. If the victim is

conscious douse the stung area liberally with vinegar –

simple household vinegar is fi ne – for 30 seconds. For

single-tentacled jellyfi sh stings pour vinegar onto the

stung area as above; early application can make a huge

diff erence. It is best to seek medical care quickly in case

any other symptoms develop over the next 40 minutes.

Australia and Thailand are now working in close col-

laboration to identify the species of jellyfi sh in Thai wa-

ters, as well as their ecology – hopefully enabling better

prediction and detection of the jellyfi sh.

Thanks to Dr Peter Fenner for the

information in this boxed text.