snake bite management

Snake bite Overview

The Bite

Identifying Venomous Snakes

general symptoms

Important terms

First aid/ Snakebite Self-Care at home

Medical research supports the following warnings

Prevention of Snake Bites

Snakebite Follow-up

Snake bites can be deadly if not treated quickly. Children are at higher risk for death or serious complications due to snake bites because of their smaller body size.

Poisonous snakes inject venom using modified salivary glands. During envenomation (the bite that injects venom or poison), the venom passes from the venom gland through a duct into the snake's fangs, and finally into its prey. Not all bites lead to envenomation. Snakes can regulate whether to release venom and how much to release. "Dry Bites" (a bite where no venom is injected) occur in between 25%-50% of snake bites. Snake venom is a combination of numerous substances with varying effects.

1. The elapid family includes:

the cobras (Naja and other genera) of Asia and Africa;

the mambas (Dendroaspis) of Africa; the kraits (Bungarus) of Asia;

the coral snakes (Micrurus) of the Americas; and the Australian elapids, which include the coastal taipan(Oxyuranus scutellatus),

tiger snakes (Notechis), king brown snake (Pseudechis australis), and

death adders (Acanthophis).

Highly venomous sea snakes are closely related to the Australian elapids.

Coral snakes have black, yellow, and red

banding and are often confused with non-

venomous king snakes. You can distinguish

a coral snake by the fact that the red

bands touch the yellow bands. They live in

the woods, marshes, and sandy areas of

the South. Coral snakes typically hide

underground and in leaf piles.

pain that is not immediate

symptoms that set in hours after the bite

convulsions

drooping eyelids

change in skin color

stomach pain

difficulty swallowing

headache

shock

paralysis

Black mamba (Dendraspispolylepis), an extremely fast, large, and dangerous African elapid.

the rattlesnakes (Crotalus) (Western diamondback rattlesnake and timber rattlesnake), moccasins (Agkistrodon), and lance-headed vipers (Bothrops) of the Americas;

the saw-scaled vipers (Echis) of Asia and Africa;

the Russell's viper (Daboia russellii) of Asia; and

the puff adder (Bitis arietans) and Gaboonviper (Bitis gabonica) of Africa.

Copperheads

Rattlesnakes are easily identifiable by the rattling sound they make with their tails. They have rings at the end of their tails that they can shake when threatened. This is a warning to back away. Rattlesnakes are the largest of the venomous snakes and cause most of the venomous bites. These snakes can be found in nearly any habitat across the country. They like open areas, rocks, and logs where they can rest in the sun.

immediate pain and symptoms

drooping eyelids

low blood pressure

thirst

tiredness or muscle weakness

The water moccasin is another pit viper. This snake is also known as a cottonmouth, for the inside of its mouth is lined with a white, cottony material. The water moccasin’s average size is between 50 to 55 inches. Adults have dark tan to black skin with faint dark brown or black crossbands. Young snakes have brown or orange crossbandswith a yellow tail. These snakes are found in the southeastern states, in or near water. They do not scare easily.

Symptoms

Water moccasin bites share symptoms with copperhead bites. Symptoms specific to both of these types include:

immediate pain and symptoms

change in skin color

shock

low blood pressure

weakness

Symptoms

Copperhead snake bites share symptoms with water moccasin snake bites. Symptoms can include:

immediate pain and symptoms

change in skin color

shock

low blood pressure

weakness

two puncture wounds

swelling and redness around the wounds

pain at the bite site

difficulty breathing

vomiting and nausea

blurred vision

sweating and salivating

numbness in the face and limbs

Bites by venomous snakes result in a wide

range of effects. They range from simple

puncture wounds to life-threatening

illness and death. The findings following a

venomous snakebite can be misleading.

A victim can have no initial significant

symptoms, and then suddenly develop

breathing difficulty and go into shock.

Local effects: These are the effects on

the local skin and tissue surrounding the

bite area. Bites by vipers and some

cobras (Naja and other genera) are

painful and tender. They can be severely

swollen and can bleed and blister. Some

cobra venoms can also kill the tissue

around the site of the bite

Bleeding: Bites by vipers and some Australian elapids can cause changes in the victim's hematologic system causing bleeding. this bleeding can be localized or diffuse. Internal organs can be involved. A victim may bleed from the bite site or bleed spontaneously from the mouth or old wounds. Unchecked bleeding can cause shock or even death

Nervous system effects: The effect on the nervous system can be experienced locally close to the bite area or affect the nervous system directly. Venom from elapids and sea snakes can affect the nervous system directly. Cobra (Naja and other genera) and mamba (Dendroaspis) venom can act particularly quickly by stopping the breathing muscles, resulting in death without treatment. Initially, victims may have vision problems, speaking and breathing trouble, and numbness close to or distant to the bite site

Muscle death: Venom from Russell's vipers

(Daboia russellii), sea snakes, and some

Australian elapids can directly cause

muscle death in multiple areas of the body.

There can be local effect of muscle death

(necrosis), or distant muscle involvement

(rhabdomyolysis). The debris from dead

muscle cells can clog the kidneys, which try

to filter out the proteins. This can lead to

kidney failure.

Eyes: Spitting cobras and ringhals

(cobralike snakes from Africa) can

actually eject their venom quite

accurately into the eyes of their victims,

resulting in direct eye pain and damage

Cytotoxins cause local tissue

damage.

Hemotoxins cause internal

bleeding.

Neurotoxins affect the nervous

system.

Cardiotoxins act directly on the

heart.

All snakes will bite when threatened or

surprised, but most will usually avoid

people if possible, and only bite as a last

resort.

Snakes found in and near water are

often mistaken as being venomous. Most

species of snake are harmless and many

bites are not life-threatening, but unless

you are absolutely sure that you know

the species, treat it seriously.

Prevent a second bite or a second

victim. Do not try to catch the snake as

this can lead to additional victims or

bites. Snakes can continue to bite and

inject venom with successive bites until

they run out of venom.

Identify or be able to describe the

snake, but only if it can be done

without significant risk for a

second bite or a second victim.

Safely and rapidly transport the

victim to an emergency medical

facility.

Individuals should provide

emergency medical care within

the limits of their training.

Remove constricting items on the victim,

such as rings or other jewelry, which

could cut off blood flow if the bite area

swells.

Monitor the person's vital signs --

temperature, pulse, rate of

breathing, and blood pressure -- if

possible. If there are signs

of shock (such as paleness), lay

the person flat, raise the feet

about a foot, and cover the

person with a blanket.

If a person has been bitten and has no major local wound effects, a pressure immobilizer may be applied. Wrap a bandage at the bite site and up the extremity with a pressure at which you would wrap a sprained ankle. Then immobilize the extremity with a splint, with the same precautions concerning limiting blood flow. This technique may help prevent life-threatening systemic effects of venom, but may also worsen local damage at the wound site if significant symptoms are present there

While applying mechanical suction (such as with a Sawyer Extractor) has been recommended by many authorities in the past, it is highly unlikely that it will remove any significant amount of venom, and it is possible that suction could actually increase local tissue damage. This technique is, in general, no longer recommended but is still listed as a treatment technique in many medical publications. If a person decides to try this technique, the instructions should be carefully followed.

First, the victim should get to an

emergency care facility as quickly as

possible because antivenin (medicine to

counteract the poisonous effects of the

snake's venom) could be life-saving.

Second, the affected limb should be

used as little as possible to delay

absorption and circulation of the venom

The most important thing to do for a snake

bite victim is to get him or her

emergency medical help as soon as possible.

There are also several outdated first aid techniques that are now believed to be unhelpful or even harmful. Do not do any of the following:

Do not use a tourniquet.

Do not cut into the snake bite.

Do not use a cold compress on the bite.

Do not give the victim any medications unless directed by a doctor.

Do not raise the area of the bite above the victim’s heart.

Do not attempt to suck the venom out by mouth.

Do not use a pump suction device. While these devices were formerly recommended for pumping out snake venom, it is now believed that they are more likely to do harm than good.

Do not use electric shocks.

Do not use alcohol.

These have not been proven effective,

may cause increased tissue damage,

and could cost the victim a limb.

Cutting into the bite site can damage

underlying organs, increase the risk of

infection, and sucking on the bite site

does not result in venom removal.

Ice does not deactivate the venom and

can cause frostbite.

The shocks are not effective and could

cause burns or electrical problems to the

heart.

Alcohol may deaden the pain, but it also

makes the local blood vessels bigger,

which can increase venom absorption.

A snakebite victim who has been released from the hospital should return to medical care immediately if he or she develops any worsening symptoms, especially trouble breathing, change in mental status, evidence of bleeding, worsening pain, or worsening swelling.

Someone who has received antivenin treatment for snakebite should return to medical care if any signs of serum sickness develop (fever, muscle or joint aches or swelling, hives). This complication usually occurs within 5-10 days after administration of antivenin.

A snakebite victim should, for the first few weeks, warn his or her physician of this fact before any routine or emergency surgery. Some snake venoms can cause difficulty in blood clotting for a week or more after the bite.

Avoid areas where snakes may be hiding, such as under rocks and logs.

Even though most snakes are not venomous, avoid picking up or playing with any snake unless you have been properly trained.

If you hike often, consider buying a snake bite kit (available from hiking supply stores). Do not use older snake bite kits, such as those containing razor blades and suction bulbs.

Don't provoke a snake. That is when

many serious snake bites occur.

Tap ahead of you with a walking stick

before entering an area where you can't

see your feet. Snakes will try to avoid you

if given enough warning.

When hiking in an area known to have

snakes, wear long pants and boots if

possible.

Theresa Galan

Cathleen Kyle Recera

Josephuse Laolao

http://en.wikipedia.org/wiki/Snake

http://www.emedicinehealth.com/snak

ebite/page4_em.htm#when_to_seek_m

edical_care

http://www.youtube.com/

http://www.healthline.com/health/snake

-bites

http://www.nlm.nih.gov/medlineplus/en

cy/article/000031.htm

Major families of snakes for most

venomous

Give example of a venomous snake

(the most common or the largest