# Rattlesnake bite treatment on the river



## co_bjread

That is a really good question, but I would definitely start with this:
https://www.rei.com/product/407144/sawyer-extractor-pump-kit

I picked it up for a Labyrinth Trip, and the nasty bugs down there, but we use it all the time on mosquitoes. It is actually amazing on mosquito bites, sucking the venom out, and quickly and seriously reducing the itch and irritation. That was worth the $17 alone, and for frequent use.

Hope I never have to use it for something nastier, but based on the experience I have had, I would expect it to do a lot for a snake bite before you rush off for help.


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## tango

My gut says go with the helicopter evacuation when weighed against the other options. A snake bite could be pretty serious. I'm not familiar with your EPIRB device, but the first responders could possibly decide whether the situation warranted immediate evacuation.


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## kfalls

Antivenom is the only treatment. Those pumps do not work. Medscape is a tertiary review site for medical professionals. First sentence. "Do nothing to injure the patient or impede travel to the ED."
80% + of rattlesnake bites are to the upper extremity. 

https://emedicine.medscape.com/article/771455-treatment


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## richp

Hi,

Victim's relatively small body mass. Unknown quantity of venom injected. Unknown potency of venom (function of time since snake's last strike). Unknown victim vulnerability to that specific toxin.

I know what I would do if it was my child.

FWIW. 

Rich Phillips


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## theusualsuspect

Evac


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## smhoeher

Get the helicopter ASAP! 

In the meantime calm her down (you too), immobilize her, and wrap the bite site with gauze. Get to and prepare the area for the helicopter to land - you may have to boat down the river farther. When the the helicopter lands follow their directions. On the Grand you're required to have big, long, orange, panels of some type of fabric or plastic to show the chopper where to land. Might be worth having them in your first aid kit or rescue bag. I think I'll start looking for and making some.


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## fcpnorman

As a paramedic- I concur the snake bite kits do not work. Also agree not all bites are equal. When a Rattlesnake bites- it is a defensive move-they are doing it because they think you are a predator. As a terrestrial animal, their rattle is a sign to hoofed animals not to step on them.
Their is a percentage of bites that where no venom is injected. 



Most protocols for EMS call for keeping the patient calm, keeping the bite location lower than the heart. Immediate evacuation to a hospital is called for, and antivenom therapy.
I would use the Epirb...


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## Commo

Looks like good advice here - best minimize movement and get to the ER.

But hey, the boys and girls in Astoria would love to come pick you up - though I'm sure they will make sure you hear about it afterwards.


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## Norcalcoastie

Getting hoisted by your own? Been there, was glad for it These are some good thoughts out here. I’d heard that snake bite kits, tourniquets and the such don’t work. I’m happy to have my EPIRB (ACR PLB), but I know that helicopter rescues aren’t easy or guaranteed. I wouldn’t want to endanger a crew if there was another option. 

Glad to hear the discussion y’all!


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## griz

Norcalcoastie said:


> I wouldn’t want to endanger a crew if there was another option.
> !


Suck it up,buttercup. It’s their job. They don’t get paid to sit around a hangar, eating donuts.


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## B4otter

Signal panels are cheap, don't mind getting wet, and take up next to no space (fold flat and put in gallon ziplock). Orange plastic tube tent for less than $10, cut into 3 X 8 foot panels and make the rangers happy... and hope you never have to use 'em. 
I got my first (tube tent) at Yellow Front back in the 70's and they lasted until a few years ago. Took 'em out to show Peggy and they were disintegrated... fortunately had another set in better condition!


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## raymo

Donuts are good! Activate that locator so they can plug the coordinates into their FMC, find a river bank area clear of high obstacles, trees, mountain sides, etc. It doesn't need to be too flat or perfect, as long as they can get one skid or tip of skid planted is all they really need, not perfect but it will work. Make an X with lifejackets, sleeping bags, tents, oars, etc., so they know their in the right place, nothing worse than flying into a group of Boy Scouts camping out in another spot with no emergency going on. I think there's a spot to swipe your credit card on the side of the helicopter if you want then to lift off, now days, those donuts are kind of pricey. I'm glad your daughter didn't get bit.


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## cayo 2

At least they had something of value at Yellow Front..have not heard that referenced in about 30 years....there used to be an insult,' yer mama buys yer clothes at Yallow Front'' say that in your best Denver west side accent''bud''...they said that about Kmart too,yeah snobby but they were not known for quality...fer de lances are the stuff of my nightmares,yer probly dead...and cascabels[sp?] the tropical and supposedly most deadly rattlesnake,have had multiple locals warn me that they like to sun by the river,like where you are scouting/portaging.There you might have to resort to local traditional [Mayan]medicine or cure,if you could get to a village or town.


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## cayo 2

i remember a hatching event in a really bad spot,the put in for lwr. Clear Creek/Black Rock take out.Right where you park, like a hundred baby rattlesnakes were hatching /just hatched some got run over by cars most were making their way down the rocky slope to the river, exactly where you carry boats down..have heard babies are more poisonous ,since they lack other defenses ,Anyone know if that is true?


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## Will Amette

cayo 2 said:


> i remember a hatching event in a really bad spot,the put in for lwr. Clear Creek/Black Rock take out.Right where you park, like a hundred baby rattlesnakes were hatching /just hatched some got run over by cars most were making their way down the rocky slope to the river, exactly where you carry boats down..have heard babies are more poisonous ,since they lack other defenses ,Anyone know if that is true?



Baby snake. Late at night is when they come out... 



It's not that baby snakes are more venomous; they have the same venom as adult snakes. They have less of it because they're smaller. However; they don't have control of when they envenomate. An adult snake likely won't invenomate you if they bite you in defense. It takes energy to make the venom; they use it to kill small animals thay are going to eat. A baby snake bites and pretty much will invenomate. That is why they are potentially more dangerous, but not more venomous. 



Most snake bites are on hands. Alcohol is often involved. It reminds me of my favorite Peggy quote about keeping your party safe. "When someone says, 'hold my beer,' you say, 'NO; don't do that.' "


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## cayo 2

nice Zappa reference..yea i just looked at snakes of Belize,although the fer de lance is super aggressive and bites a lot they do not usually envenomate you and you actually have a fair amount of time to get treatment..so you are not 'probly dead' ..the locals sometimes call them tres minutos ,3 minutes,so i thought you are effected right away.but that is apparently wrong...the photos of untreated bites are extremely gnarly..


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## davbaker

Man, I cannot believe Sawyer advertises their extractor kit for snake bites. The medical and EMS world has long since abandoned that practice. As a physician, I would 100% recommend an air evacuation in this scenario. While it is unpredictable how sick someone will get from a bite (yes a certain percentage will be dry bites), people do die, end up in the ICU, have to get their limbs filleted open due to something called compartment syndrome. The patients who die tend to be at the extremes of age - kids are more vulnerable due to their body weight. I would consider a snake bite way more legitimate than probably 90% of the emergency evacuations that take place.

Funny story. I have a friend who is an ER doc near Hood River. Some old timer, steelhead fisherman came off of the Deschutes (had been floating the lower section) with a snake bite to the hand. His hand was swollen up like a grapefruit. Of course, he was trying to be the hero and chase a snake out of camp with a stick. In the ER he was given the first dose of anti-venom and they planned to admit him to the hospital to finish the series of shots. He pondered this for a second but decided the steelhead run that Fall was too good, so he left against medical advice and went back to the river.


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## blueotter

That's a funny story....??


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## theusualsuspect

Yeah. Patient made a choice AMA and decided to go fishing instead. That’s funny.


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## davbaker

Maybe it helps being a steelhead fisherman to get it and think it’s funny. Sorry if you couldn’t see the humor


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## JakeH

I would evacuate. I had a buddy bitten by a venomous snake. Not sure if it was a timber rattler or copperhead. He never saw it. He took a swim and while walking the bank to retrieve his yard sale, he said he thought he stepped on a stick. Obvious punctures, maybe about 1.75" apart. We were roadside. Got him out and rushed him to the ER. He was in bad shape. By the time we got to the ER he was in shock He had several rounds of anti venom (that stuff isn't cheap). He eventually was ok but he was in severe pain for several days. If I were in a backcountry situation, I would not hesitate to hit my SoS on the InReach.


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## blueotter

Sorry you didn't see MY humor...
I did get it and enjoyed the story. Trying to be funny myself, but sometimes it doesn't translate well typing.


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## Conundrum

Fly them. I have a buddy who flew out of Hell’s. I won’t say a good decision got him bitten but the helicopter ride probably saved his life and for sure saved his arm. 

We were camped at Loon on MFS and a ranch hand came riding into camp in bad shape. He got zapped in the leg and didn’t look good. He rode 8 mi back to the ranch from where it happened. There was a helicopter there in an hour From when I saw him. He called the ranch when the bite happened and they sat phoned out immediately. 

I grew up on the Salmon river breaks in central Idaho. I’ve had some close calls by surprise. I really don’t like rattle snakes. If you get bit, call it in. And google image compartment syndrome like mentioned above.


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## Conundrum

Oh. We’ve also killed some at a caretaker’s request and ate them. It’s not worth the risk of messing with them just to eat. They only taste like what you season them with. In our case, Old Bay. And there isn’t as much meat as you would hope...barely an appetizer unless you get a few of them and they are creepy to dress. We were “relocating” them because it was an area kids frequented on a daily basis.


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## NoCo

While we have medical professionals answering this thread and are not entirely pissed off with well...people like me. Im going to ask a relevant question. 

Ive been hearing that if someone gets bit, the best thing you can do for them other than getting medical attention is the give them a antihistamine, like benadryl. Is that true or did them old timers that go shooting out on the Pawnee grass lands just like blowing smoke up everyone's ass?


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## dsrtrat

Lots of resources from these folks.


https://www.snakebitefoundation.org/blog/2018/9/6/how-to-survive-a-snakebite-in-the-wilderness


Learned some first aid information I had heard about before about marking the swelling progression. Good visual guide on how to do it.


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## davbaker

blueotter said:


> Sorry you didn't see MY humor...
> I did get it and enjoyed the story. Trying to be funny myself, but sometimes it doesn't translate well typing.


Blueotter. Sorry for the snarky response. I honestly was worried that my story came off poorly, like I was laughing at some dumb old fisherman making a bad decision. Which I guess I kind of was, yet I understand how steelhead can cloud one’s judgement!


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## fcpnorman

To be honest with snakes best practice is prevention. They are on the lower end of the food chain and as prey animal- their first instinct is to hide or escape. I have surprised a few- once while running in large group in rank- a rattle snake waited to rattle until about 10 of the 25 people had passed over it. Pretty comical to watch all 25 people scatter...
When I teach courses on dealing with snakebites to EMS, I recommend utilizing the radiation principle- Time..Distance..Shielding. 

Give the animal time to get away from you. Place distance between the animal and you. Exit to a safe location that isolates you( and your dog) from the animal..


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## griz

Or just huck a big rock on it and get on with your day.


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## raymo

*good information...*



dsrtrat said:


> Lots of resources from these folks.
> 
> 
> https://www.snakebitefoundation.org/blog/2018/9/6/how-to-survive-a-snakebite-in-the-wilderness
> 
> 
> Learned some first aid information I had heard about before about marking the swelling progression. Good visual guide on how to do it.


For many years in First-Aid classes we were instructed to use the tourniquet and cut and suck procedure if a hospital was not readily available. In remote areas in the early days help and rescue was left up to you and your buddies, no sat-phones, cell phones, 911 was non existent, communication was very very slow. The calvary was not going to come charging to save you ass within hours or even days. I also thank the Medical Dr's on Mountain Buzz for sharing their hands on approach and advice offered to us free of charge, Steel Head fisherman still have to pay 50% though.


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## smhoeher

I'm an old Boy Scout and outdoor man from years ago. I used to criticized people depending on their cell phones for rescue. Most of us now carry cell phones. I won't hesitate to call for help it is really needed. Technology is available and can be our friend. We're also often in the middle of nowhere so should be educated and self sufficient. Don't make the call until is truly needed, like a rattlesnake bite. 

On a different but similar subject, as an old Boy Scout and outdoors man, I still think the ability to read a map and use a compass is way more important than having GPS.


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## co_bjread

So, when I brought up the Sawyer Extractor, I was thinking that its use in the first few moments, while calling the helicopter, and getting set up, might make some difference. I have fortunately not had to actually deal with a snake bite, and I get the seriousness of getting medical help pronto, but is there no place for them on a snake bite even while waiting for the helicopter to show up?

They are relatively cheap, and I have had success with it on other stuff, so if I were in the situation I'd probably give it a shot, thinking it isn't going to make the situation worse, as long as it doesn't delay the real help showing up.

And I guess I'll ask if anyone know how effective they are on scorpions stings? That was my initial thought when picking one up.

But honestly, the reduced irritation for myself and my kids from the common and frequent mosquito bites has made it worth carrying.


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## co_bjread

Guess I found the answer to my own question. 

https://www.snakebitefoundation.org...ommercial-snakebite-kits-and-venom-extractors

Thanks MountainBuzz for preventing me form doing something stupid.


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## blueotter

Great article. Thanks


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## fcpnorman

If a bite occurs:
Keep the person calm
Keep the bite location below the level of their heart
Apply a dry dressing bandage
Mark the area of the swelling with a pen to track the swelling
Apply an ice pack to help reduce pain and swelling
A constricting band can be applied above the bite sit- not a tourniquet- ( not totally proven to work).
Antihistamine may not help much- the venom from a rattlesnake is a neurotoxin, however the person may release histamines in response to the bite.
Get the patient to an emergency department as quickly as possible.


For dogs:
We took our dogs to a rattlesnake avoidance class. I thought it might be BS, but my wife wanted to try it. The course trains the dog to be afraid of the snake by; sight, smell and sound.
A few months after the training we were walking on a trail with them, and all of the sudden they both bolted back behind us. And sure enough about 25 feet ahead there was a rattlesnake on the trail..


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## trevko

Norcalcoastie said:


> Getting hoisted by your own? Been there, was glad for it These are some good thoughts out here. I’d heard that snake bite kits, tourniquets and the such don’t work. I’m happy to have my EPIRB (ACR PLB), but I know that helicopter rescues aren’t easy or guaranteed. I wouldn’t want to endanger a crew if there was another option.
> 
> Glad to hear the discussion y’all!


I hear ya and understand not wanting to put others at risk. In my time I've been in two air mishaps and have lost friends to mid-airs. 

That being said, if it were on my trip I would make the call if I thought they were envenomated. From all of my training and from what I've read the extractors don't work and could cause more damage (if you do any of the old school cut-n-suck stuff).


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## raymo

Norcalcoastie, thank you for your service in the United States Coast Guard, no telling how many lives you have saved and rescued from harm, while putting your own life at risk. This post has educated me on how important medical assistance is need with a rattlesnake bite, and how past information was relied on as a first aid treatment, were wrong. Thank you.


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## Roguemeup

*Rattlesnakes*

This one hits very close to home for me. See the link below. I'm the brother.

https://www.bendsource.com/bend/sunk-by-a-rattlesnake-bite/Content?oid=6260914

I bought a satellite phone immediately after this incident. I take it with me on every trip. Helicopter Evacuation is the only solution. 

Jake took 20 vials of antivenom. 

He's doing great today.


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## bellsagna

Garmin InReach or InReach mini. They are GPS devices that also have an SOS function. They are relatively expensive (~$300) and require a monthly subscription based on the plan you choose, but they use a satellite network that is suppose to be more reliable than the SPOT devices. I have the basic plan for the InReach mini and it runs about $10/month. I mostly kayak in an area that doesn't have cell service, and I don't bring my phone with me anyway, so it gives me peace of mind knowing if shit hits the fan I can still get some help.


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## Norcalcoastie

Lots of great discussion here! Certainly a lot to learn from others in this community. I appreciate the feedback.


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## NoCo

+1 for them crazy old bastards out on the pawnee. It seems an antihistamine like benadryl is a helpful part of a first aid kit. I'm going to make sure I replace my sharpy every year.


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## dsrtrat

fcpnorman said:


> If a bite occurs:
> Keep the person calm
> Keep the bite location below the level of their heart
> Apply a dry dressing bandage
> Mark the area of the swelling with a pen to track the swelling
> Apply an ice pack to help reduce pain and swelling
> A constricting band can be applied above the bite sit- not a tourniquet- ( not totally proven to work).
> Antihistamine may not help much- the venom from a rattlesnake is a neurotoxin, however the person may release histamines in response to the bite.
> Get the patient to an emergency department as quickly as possible.
> 
> 
> May want to check your source on the ice thing. Constricting band is not recommended as well.
> 
> 
> 
> From the website. https://www.snakebitefoundation.org/blog
> 
> 
> Good information there on antihistamine use as well.
> 
> 
> *Ice:* Do not use ice for snakebites! Ice causes the smaller blood vessels to constrict and when combined with viper venoms it can produce dramatic tissue damage. Again, better to let the swelling happen and focus on getting to a hospital.


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## sarahkonamojo

Ordered an InReach mini earlier this week due to this thread. Seems like someone on the trip always had one. Well, now I will as well. It was $300 REI.


Sarah


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## cjb_pdx

Same here - InReach Mini on order from REI as we speak. That article from the Bend paper is a bit chilling - I've camped many times at that very spot (Harris) on the lower Deschutes.


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## raymo

I agree in this age of advanced and high tech electronics and satellite systems, too not have an emergency(SOS) personal locator transmitter(ELT, PLB, etc) or sat-phone when venturing into remote areas with family and friends is denying yourself of a valuable tool in an extreme emergency situation, when your first-aid-kit can not solve the life or death situation. When minutes or hours count. An old and time tested piece of equipment still used to this day is a signal mirror. SOS(... _ _ _ ...) flashes(work's great with a flashlight at night too), they doesn't have to be perfect, keep flashing even if it's wrong. Plus a flashing mirror is very bright and will pin point your location to search and rescue well before they will see you , by about 5 to 10 miles away, easily. PS a flash of a mirror can be seen 180° degrees up or down, left or right of the flash, so it doesn't need to be directly pointed at anything in particular. Just slight movements of the mirror in your hand between your fingers and thumb, in the direction of the sun will do the trick. Practice with the mirror by going out into the street, get about a half a block or closer, face the sun and flash each other.


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## semievolved

*second this...*

really glad to see you posted this, i just read the other comment and wanted to make sure someone said no no to the ice or constricting band idea. i think both ice and constriction band are not used anymore because they tend to concentrate damage to a small area and that can mean loss of limb due to extensive tissue damage. the consensus now is that a rattlesnake bite is vary rarely fatal and won't cause lasting damage but that the various remedies can cause serious, lifelong problems. still sounds like an evacuation is the best bet if you're anywhere you can do that but, if not, keep calm, cool the entire body a bit if possible, and wait it out. certainly easier said than done!



May want to check your source on the ice thing. Constricting band is not recommended as well. 



From the website. https://www.snakebitefoundation.org/blog


Good information there on antihistamine use as well. 


*Ice:* Do not use ice for snakebites! Ice causes the smaller blood vessels to constrict and when combined with viper venoms it can produce dramatic tissue damage. Again, better to let the swelling happen and focus on getting to a hospital.[/QUOTE]


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## calendar16

great, informative thread. heard a rattler rattling on a scout of tappan falls 10 years ago...surely left it alone.

this thread also inspired me to purchase an Inreach Mini. used to have a version 1 Spot but the technology has come a long way. it's definitely cheap insurance for a life and death situation.

SYOTR!


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## semievolved

oops, meant "very rarely fatal" not "vary rarely fatal".





semievolved said:


> really glad to see you posted this, i just read the other comment and wanted to make sure someone said no no to the ice or constricting band idea. i think both ice and constriction band are not used anymore because they tend to concentrate damage to a small area and that can mean loss of limb due to extensive tissue damage. the consensus now is that a rattlesnake bite is vary rarely fatal and won't cause lasting damage but that the various remedies can cause serious, lifelong problems. still sounds like an evacuation is the best bet if you're anywhere you can do that but, if not, keep calm, cool the entire body a bit if possible, and wait it out. certainly easier said than done!
> 
> 
> 
> May want to check your source on the ice thing. Constricting band is not recommended as well.
> 
> 
> 
> From the website. https://www.snakebitefoundation.org/blog
> 
> 
> Good information there on antihistamine use as well.
> 
> 
> *Ice:* Do not use ice for snakebites! Ice causes the smaller blood vessels to constrict and when combined with viper venoms it can produce dramatic tissue damage. Again, better to let the swelling happen and focus on getting to a hospital.


[/QUOTE]


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