"THE EFFECT OF SNAKE BITE RESCUE TRAINING ON HANDLING

OINJURY VICTIMS ON HONEY FRUIT FARMERS IN TASIKMADU VILLAGE,

PALANG TUBAN"

Ahmad Dika Pramsisto1, Kusno Ferianto2, Tiara Putri Ryandini3

123 Nursing Study Program STIKES Nahdlatul Ulama Tuban

ABSTRACT
Early handling of injury due to snakebite is something that needs to be considered in
order to avoid fatal events due to the injury. Handling Snake bite injury is not yet known by
many people and they only do makeshift handling by tying a rope and also slicing the skin
of the snakebite. The purpose of this study was to determine the effect of snake bite rescue
training on handling injured victims in honey starfruit farmers in the village of Tasikmadu
Palang Tuban.
This research method is pre-experimental (one group pre-post test design). The
population in the study amounted to 35 people, the sample was taken using systematic
random sampling totaling 32 respondents. The first SPO research instrument was handling
snake bites and questionnaire sheets.
The results showed a change in scores of 30 respondents who experienced an increase
and 2 respondents who were still settled. Analysis of research data using the Wilcoxon test.
Wilcoxon test results obtained Asymp results. Sig. (2-tailed) = 0,000 with a significant value
<0.05, then H1 is accepted. So it can be concluded that the Snake Bite Rescue Training has
an influence on the Behavior of Injuring Victims in Honey Belimbing Farmers. And it is
hoped that Snake Bite Rescue Training can be applied by starfruit farmers for handling
when exposed to snake bites.
Keywords: Snake Bite Rescue Training, the behavior of injured victims

PRELIMINARY many people and they only do

Snakebite cases include emergency
cases related to the environment, work
and seasons that occur quite a lot in
various parts of the world in rural
areas. Snake bites can cause injuries in
the form of disability injuries and
death. Injury is a damage to the
structure or function of the body due
to a coercion or physical or chemical
pressure
Injuries to snake bites can be at risk of
disability and death. Snake bites are
very deadly that we need to be aware
of, whether we accidentally stepped on
or accidentally entered the area of his
life. The death or death toll caused by
snake bites is a variety of causes, one
of which is the lack of knowledge and
ability in handling snakebite injuries.
Early handling of injury due to
snakebite is something that needs to be
considered in order to avoid fatal
events due to the injury. Handling
Snake bite injury is not yet known by
makeshift handling by tying a rope
and also slicing the skin of the
snakebite.
Snake bites are more common in
tropical regions and in areas where the
main occupation is farmers. People
who are bitten by snakes for holding
or even being attacked by snakes are a
significant cause in the United States
there are an estimated 45,000 snake
bites per year in the United States,
most in the summer, around 8,000
people are bitten by poisonous snakes.
(WHO, 2016) states that between half
a million snake bites and between
30,000 and 40,000 snake bite deaths
every year in the world as a whole,
there are between 25,000 and 35,000
deaths in Asia while in Indonesia the
number of snake bite victims is based
on Remote Envenomation Consultant
Service
(RESC) 2017 diseases due to
snakebite reach 135,000 per year. The
number of patients died due to
improper handling reached 4.8 percent
of the value of the data (Tri maharani,
2017). The initial survey conducted by
researchers on April 10, 2019, after an
interview conducted by the head of the
Belimbing farmer association in 2017-
2018 in Tasikmadu Village, Palang
sub-district, Tuban District, found 35
cases of snake bites on workers and
starfruit garden farmers, from 20
honey starfruit farmers in the village
Tasikmadu, 15 (75%) people said that
they did not know how to first aid in
snake bites and 5 (25%) people knew
how to first aid but did not according
to the procedure.
Snakes are categorized into venomous
and non-venomous, venomous snakes
have a pair of fangs in the upper jaw,
where the fangs have channels that can
be injected into the body of their prey
subcutaneously or intramuscularly. It
can be a substance or substance that
functions to paralyze prey and also
plays a role in the self defense system.
Snake venom not only consists of a
single substance, but is a complex
mixture, especially protein, which has
enzymatic activity, the toxic effect of
snake venom when biting its prey
depends on the species, snake size,
sex, age, and mechanical efficiency of
the bite (whether only one or both
fangs pierced the skin), and the
number of attacks that occur and the
effects can be local (around the
wound) and even systemic.
Farmers are at high risk of being bitten
by snakes, because farmers work in
nature while snakes live in nature with
a majority of plants. Signs and
symptoms of snake bites generally
vary according to the species of snake
that is biting and the amount that can
be injected into the victim. These
symptoms include signs of fang
marks, local pain, local bleeding,
bruising, inflammation, blisters, local
infections, and tissue necrosis
(especially due to snakebites from the
family Viperidae) and if these bites are
not treated immediately will cause
physical disability.
This deadly snake bite, we need to be
aware of by having good knowledge
about how first aid is done, then good
knowledge might be able to reduce
mortality in snake bite cases. Today's
society may not yet and seldom know
how to first aid if exposed to snake
bites, therefore it is necessary to
increase knowledge about first aid in
snake bites in the form of snake bite
rescue. The principle of handling
snakebite is to inhibit the absorption
and spread of snake venom, neutralize
venom and treat complications. Snake
bite rescue training is expected to
increase the ability of farmers in
handling snake bite victims by
increasing the ability and knowledge
of farmers to reduce the incidence of
disability or death due to snakebite.
Based on the description above,
researchers are interested in
researching about "the effect of
Sanake bite rescue training on the
handling of injured victims in honey
starfruit farmers in Tasikmadu Village,
Palang Tuban".
RESEARCH METHODS
This research is a type of "pre-
experimental" researchmenggunakan
research design "one group pre-post
test design", namely by revealing a
causal relationship by involving one
subject group (Nursalam, 2016). The
data collection approach in this study
is a cross sectional approach, a type of
research that emphasizes the
measurement / observation of
independent and dependent variable
data only once at that time. (Nursalam,
2016) In this study the researchers
took the subjects based on criteria,
where the research respondents were
some farmers with 32 respondents
with a simple random sampling No. Education f Prosentase
technique that is dividing the (%)
population into groups. Then 1. Elementary 17 53%
randomly selected as a representative school
of the population, then all selected 2. Middle 10 31%
elements are used as research samples School
(Nursalam, 2015). 3. High school 5 16%
RESULTS AND DISCUSSION total 32 100%
General Respondent Data includes: Source: researchers' primary data for
1. Age 2019
Table 5.1 Distribution of Based on table 5.2 it can be seen that
Respondents by Age among star all 32 (100%), most 17 (53%)
fruit farmers in Tasikmadu Village, respondents were elementary school
Palang District, Tuban Regency in graduates and a small portion were 5
2019 (16%) senior high school graduates.
No Age f Persentase Specific data obtained in this study
1. 25-35 9 28% include:
2. 36-45 7 22% 1. Management of Snake Bite Injury
3. 46-55 16 50% Victims Before being given Snake
total 32 100% Bite Rescue Training.
Source: researchers' primary data for Table 5.4 Distribution of Handling
2019 of Snake Bite Injury Victims Before
Based on table 5.1 it can be seen that being given Snake Bite Rescue
all 32 (100%), half (16%) of Training in Tasikmadu Village,
respondents aged 46-55 years and a Palang District, Tuban Regency in
small proportion of 7 (22%) aged 36- 2019.
45 years No. Handling f Prosentase
2. gender before (%)
No. Gender f Prosentase( 1. Well 5 16%
%)
1. Man 8 25% 2. Enough 9 28%

2. Girl 24 75% 3. Less 18 56%

Total 32 100% total 32 100%

Table 5.2 Distribution of

Respondents by Gender in star
fruitPalang District, Tuban Regency
in 2019
Based on table 5.2 it can be seen that
all 32 (100%), mostly 24 (75%).
respondents were female and some 8
(25%) were male.
3. Education
Table 5.3 Distribution of
Respondents by Last Education in
leatherback farmers in Tasikmadu
Village, Palang District, Tuban
Regency in 2019
Source: Researcher's Primary Data,
2019
Based on table 5.4 it can be seen that
of all respondents 32 (100%) before
being given Snake Bite Rescue
Training most of the 18
(56%)respondents had less snake bite
injury handling and a small portion of
5 (16%) respondents had handling bite
injury victims good snake.
 Management of Snake Bite Injury Wilcoxcon Test Asymp. Sign (2-sided) = 0,000
Victims After Snake Bite Rescue Source: Researcher's Primary Data, 2019
Training.
Table 5.6 results from the data of 32
Table 5.5 Distribution of Handling of respondents who showed that before
Snake Bite Injury Victims After Snake being given treatment, most 18 (56%)
Bite Rescue Training was given in had poor handling of snake bite injury
Tasikmadu Village, Palang District, victims and a small portion of 5 (16%)
Tuban Regency in 2019. had good handling of snake bite injury
No. Handling F Prosentase( victims whereas after being given
after %) treatment, almost all 25 (78%)
respondents had good handling of
1. Well 25 78%
snake bite injury victims and a small
2. Enough 5 16% portion of 2 (6%) respondents had
poor snake bite injury handling.
3. Less 2 6% Based on the analysis in this study
Total 32 100% using the Wilcoxon Test with
significance level α = 0.05 and the
calculation is done using the SPSS
Source: Researcher's Primary Data, 2019 software application for windows, the
Based on table 5.5 it can be seen that results obtained with a value of p =
of all respondents 32 (100%) after 0,000. Because p = 0,000 <0.05, H1 is
being given Snake Bite Rescue accepted, it means that there is an
Training, almost all 25 (78%) influence of snake bite rescue training
respondents had good handling of on handling injured victims in honey
snake bite injury victims and a small starfruit farmers in Tasikmadu Village,
portion of 2 (6%) respondents had Palang District, Tuban Regency.
handling bite injury victims the snake This shows that there is an effect of
is lacking. Snake Bite Rescue Training on
Analysis of the Effect of Snake Bite Handling Injury to Blimbing Honey
Rescue Training on the Behavior of Farmers in Tasikmadu Village, Palang
Handling Injury to Honey Belimbing Tuban
Farmers in Tasikmadu Village, Palang DISCUSSION
District, Tuban Regency
Table 5.6 Analysis of the Effect of 1.Management of Snake Bite Injury
Snake Bite Rescue Training on Victims Before being given Snake
Handling of Cedara Victims in Bite Rescue Training in Tasikmadu
Honey Belimbing Farmers in Village, Palang District, Tuban
Tasikmadu Village, Palang District, Regency
Tuban Regency in 2019.
Based on table 5.5 results from 32
Quite Quite respondents' data that show that before
TOTA
Farmer's Well lacking lacking being given treatment, most of the 18
No. L
Behavior (56%) had less snake bite injury
f % F % f % f % handling, while after being given
Sebelum 56 3 100 treatment, almost all 25 (78%)
1. Perlakuan 5 16% 9 28% 18 respondents had handling bite injury
% 2 %
Sesudah victims good snake.
3 100 The results of data analysis
2. Perlakuan 25 78% 5 16% 2 6%
2 % used in this study is the Wilcoxon test
with a significance level of 0.05.
Statistical test results using the
Wilcoxon test obtained p value =
0,000 (p value <0.05). This shows that
there is an effect of Snake Bite Rescue
Training on Handling Injury Victims
in Honey Belimbing Farmers in
Tasikmadu Village, Palang Tuban.
Based on the data it is known
that the majority (56%) of respondents
before being given a snake bite rescue
showed unfavorable behavior in
handling victims of snake bite injuries,
namely their knowledge as follows:
throwing away can be by sucking,
slicing the wound, rubbing with
chemicals on the bite, compressing
with water heat or ice and binds firmly
to the bite. And after being given
training, the majority (78%) of
respondents showed good behavior in
handling snakebite injuries, namely
their knowledge as follows: resting
(imibilizing) the victim, giving a hard
board / handler along the leg or hand,
bandaging from the palm to the top
(fingers) not bandaged), bandages the
elbows and arms in a 90 ° bend
position and uses mitela to hold the
hand.
According to Kaswana (2011)
the purpose of training is to improve
the technical, theoretical, conceptual
and moral capabilities of employees so
that later employees will be able to
achieve optimal work results so that
employees are eager to work at the
company. in accordance with their
area of work. Training for employees
is one of the most important
investments made by an organization
in smoothing the course of
development activities. According to
Veithzal Rivai (2004) factors
supporting the effectiveness of
training include: training materials or
content, training methods, trainers,
training participants, training facilities,
training evaluations
According to the researchers the
changes that occurred in the pre-post
showed that there was an increase in
the behavior of farmers in handling
injury victims in honey starfruit
farmers in the village of Tasikmadu
Palang Tuban. Training in handling
snakebite injuries in the Blimbing
honey orchard in Taasikmadu village
of Palang Tuban is very effective
given to improve the behavior of
farmers in handling snake bite injury
victims because of several factors
including the material and training
methods as well as the means of
training. However, there were 2
respondents who experienced an
increase in the score but still in the
fixed category caused by external
factors in the form of a lack of
concentration of respondents in
attending the training so that it can be
concluded that in this case there was a
lack of effectiveness of the training
caused by the trainees themselves.
To get effectiveness in training it must
pay attention to the factors as the
material or content of the training,
training methods, trainers, trainees,
training facilities, training evaluations
so that the handling of victims of
snake bite injuries can be handled
appropriately according to the existing
SPO.
CONCLUSIONS AND
RECOMMENDATIONS
CONCLUSION
From the results of this study it can be
concluded that:
1. Most respondents before being
given a snake bite rescue training in
Tasikmadu Village, Palang District,
Tuban Regency had less behavior.
2. Almost all respondents after being
given snake bite rescue training in
Tasikmadu Village, Palang District,
Tuban Regency have good behavior.
3. There is an effect of providing
snake bite rescue training to the
handling of injured victims in Honey
Belimbing Farmers in Tasikmadu
Village, Palang District, Tuban
Regency.
RECOMMENDATIONS
The advice given is as follows:
1. For health institutions
It is expected that health institutions
will train cadres and puskesmas staff
in handling snake bite injuries so as to
reduce the incidence of disability and
death from snake bite injuries.
2. For Further Researchers
It is hoped that further researchers will
be able to develop and conduct
research development on training in
handling snake bite injuries by taking
into account several factors, namely:
training material or content, training
methods, trainers, training
participants, training recommendations
and training evaluations, and being
able to add control groups to the
research to get more valid results.
3. For the community
The community is expected to be able
to apply the handling of snake bite
injury victims independently as the
first treatment to reduce the severity of
the snakebite injury
BIBLIOGRAPHY
Alligood, M, 2012, Nursing Theory
Expert, Vol 1, Pg. 149-174,
Indonesia
Candra, W, 2018, Occurrence and
Characteristics of Injury to Farmers
in Kalisat District, Jember
Regency, Thesis, S1 Study Program
Faculty of Nursing, University of
Jember
Cholifah, Tri Andriani, et al, 2015,
The Speed of Snake Bite Wound
Swelling With Incisions And Non-
Incisions, Bandung
Masher, W, 2015, The Effect of
Training on Employee Performance
at the Rokan Hulu Regency
Inspectorate, Faculty of Economics
Study Program, University of Pasir
Pengaraian
Medikamto, et al, 2017, Viperidae
Snake Bite: Serial Case, "Periodical
Medical Science Duta Wacana",
Vol.2 No.2, Page 361-374, Jakarta
Ningrum, 2017, Level of Nurse
Knowledge About Snake Bite in
Emergency Room, Thesis, College
of Health Sciences, Asylum Insan
Banjarmasin
Nugroho, T, 2016, Theory of
Emergency Nursing Care,
Yogyakarta
Nursalam, 2016, Concept and
application of Nursing Science
Research Methodology. Salemba
Medika, Jakarta
Phahlevi, R. 2017. Factors Affecting
Rice Farmer Income in Padang
Panjang City. Essay. Padang State
University
Pitriono, 2014, The Use of Allium
Sativum Extract for the Treatment
of Venomous Snake Bites, Thesis,
Nursing S1 Study Program,
Kusuma Husada College of Health
Sciences
Pratama, G, 2017, Snake Bite in the
Region of Sinusra Manus, Faculty
of Medicine, University of
Lampung
Rachmawati, Dina, 2018, Farmer's
Knowledge of First Aid in Snake
Bite. Final Project (D3) thesis.
Muhammadiyah University
Ponorogo
Rifai, A, 2011, The Difference
Between Snake Bite Wounds with
Incisions and Without Incisions
Against the Speed of Decreased
Swelling of Wounds in Pacitan
Hospital, Ministry of Health
Surakarta Health Polytechnic
Department of Nursing

Rosyidah, R, 2017, The Effect of

Giving Cold Therapy with Ice
Massage Technique on Lower Back
Pain in Female Farmer Groups in
Sugiwaras Village, Thesis, S1
Study Program of Nahdlatul Ulama
High School of Health Tuban

Soemarko. 2013. Evaluation of

Training and Education Results for
Pre-Hospital Management of
Injured Patients. Brawijaya Medical
Journal.

Suryati, I, 2018, Relationship between

Knowledge Level and Community
Attitudes with Early Handling of
Animal Bites, Pioneer College of
Health Sciences

Tygerson, A, 2009, First Aid, fifth

edition

WHO, 2016, Guidelines For

Management of Snakebites

Yanmed, Dirjen, 2017, Regarding the

Applicability of Nursing Care
Standards, No. 00.03.2.6.7637,
Surakarta