WHAT TO DO
Be careful out there…
Although the chances of being bitten by a snake are relatively small, the chance is still there, and knowing what to do when a bite does happen, can save a life. It is important to remember though, that deaths from snake bites are relatively few when compared to deaths by other creatures, for example such as the infamous mosquito.
With the advent of reliable antivenom, more constructive first aid techniques, and advanced medical care, a bite nowadays is survivable. And of course, don’t automatically assume that the snake that bit you was venomous. There are more non-venomous snakes out there than there are venomous ones. It may also be comforting to know, that even if bitten by a venomous snake, no venom may have been injected. A snake has control over its venom system, and can deliver what is commonly called a ‘dry bite’. PREVENTING A BITE
As the saying goes “prevention is better than cure”, and there are a number of things you can do to decrease your chances of being bitten: 1. If you spot a snake, leave it alone, and remain still. By nature snakes will avoid humans if at all possible. Just let it go about its business. Snakes respond to movement, so if you remain still they do not perceive you as a threat. It is only when you move that they will strike. Be aware that some snakes feign death when antagonised, only to bite the inquisitive hand which attempts to pick them up. Oh, and a venomous snake that is actually dead can still inflict a fatal bite should you prick a finger on one of its fangs. So, dead or alive leave well alone! 2. Avoid stepping over logs or rocks if you cannot see where you are about to place your foot, because there could be a snake sheltering there. Instead stand on top of the log or rock and take a big stride forward to clear it. It is often said, if you are in a group, it is the second or third person who is most likely to be bitten, because the first alerts the snake and the second or third feels the wrath of its annoyance, so be aware of your surroundings at all times. 3. When crouching down, look to see where your
knees are going to land. I know of a hunter who
knelt on a puff adder he didn’t see hidden in the grass. And a puff adder is a nasty snake to be bitten by; they are responsible for around 80% of all snake bites in Africa. 4. If camping, wear sensible shoes around camp and be careful when picking up firewood. 5. When answering the call of nature, watch where you relieve yourself. Make sure if you have to squat down that you are not going to do anything on a snake that it would take exception to. I know a lady who was bitten on the backside under such circumstances; fortunately it was by a harmless snake.
WAS IT VENOMOUS OR NOT?
If the unfortunate does happen and you are bitten by a snake, it is important to determine whether it was venomous or not. If you did not see the snake, this can be done by looking at the imprint of the bite mark. A bite from a venomous snake will generally leave two quite distinct puncture marks; as though someone had stabbed you with knitting needles. A non-venomous snake will leave two crescent-shaped marks with numerous ‘pin-pricks’.
DIDITACTUALLYINJECTANYVENOM?
Snakes primarily use their venom to kill prey but also as a defence mechanism, so do not wantonly waste it. As I have mentioned already, a venomous snake has control over the amount of venom they inject into their prey/victim and can instigate a dry bite. This may be the reason why many so-called natural remedies are apparently effective in curing snake bites; the snake either did not inject any venom, or it was simply a harmless species.
SIGNS AND SYMPTOMS
Before beginning any form of treatment, sit the victim down and wait calmly to see what symptoms, if any, develop. If there are no symptoms after 15 to 20 minutes, you can be pretty sure it was either a dry bite or a harmless snake. That being said, the one exception is the boomslang ( Dispholidus typus). Symptoms from this snake’s bite may take 24 hours to develop. But to be bitten by a boomslang, you would have had to been up a tree and very unlucky.
With neurotoxic snakes (cobras, mambas, etc.) the bite itself is not painful but a gradual tingling sensation moving upwards from the bite wound and progressive paralysis will develop. This leads to difficulty in swallowing, slurred speech, giddiness and drooping eyelids. Death is due to paralysis of the diaphragm that makes it difficult to breathe.
Viper bites (puff adders, etc.) are extremely painful. The bite marks ooze blood and are accompanied by swelling that spreads rapidly up the bitten limb. Bleeding in other regions of the body such as the gums and nostrils is not uncommon, followed by nausea and vomiting. The bitten limb will also take on a bruised appearance with signs of blistering. An elevated heart rate may be detected which, if the victim is in poor health or frail, may lead to a heart attack. Blood may also be present in the urine.
WHAT SHOULD I DO?
Keep an eye out for signs of shock. Individuals bitten by nonvenomous snakes have been known to die as a consequence of shock on the assumption that they had been bitten by a venomous snake. So, reassuring the victim and keeping him as calm as possible play an important role in his survival. Remove watches, rings and any other constricting items. If symptoms do follow a bite, first aid treatment is extremely effective.
However, before I cover those, snakebite treatments are full of myths. So, here is what you should NOT do: »
» DO NOT CUT AND SUCK THE BITE The time-honoured procedure of cutting and sucking the bite is extremely dangerous, and a lot of medical studies have cast doubt on its effectiveness anyway. And, of course, the person doing the sucking runs the risk of exposure to infectious blood diseases. DO NOT USE A TOURNIQUET
The idea behind tying a tourniquet tightly around the bitten limb is to limit the spread of venom. However, under normal circumstances you should NOT use it as a snake bite treatment. At the outset, the tourniquet might seem effective in ‘containing’ the venom in one area but you risk cutting off blood flow, starving the limb of oxygen thus killing it. There is also the risk of toxic shock syndrome, whereby, as the limb begins to break down, toxins are released into the body as soon as the tourniquet is loosened. The medical consensus is, don’t do it.
DO NOT USE SUCTION
There are many suction kits on the market which, when placed over the bitten area, are said to draw the venom out. Again, research has shown that these kits have little, if any, effect in removing venom from the bitten area, and can actually cause tissue damage.
DO NOT USE POTASSIUM
I have heard of people tipping potassium permanganate on the bite and then igniting it in the belief that it will neutralise the venom. However, the only thing it will do is cause a serious burn!
DO NOT PLACE ICE OR A COLD PACK ON THE BITE
This has no effect on breaking down the venom, and may actually make the bite area worse.
WHAT CAN YOU DO? THE BEST FIRST AID PROCEDURE
The most effective first aid treatment is the application of a pressure/immobilisation bandage. Some research question its effectiveness, but I must point out a pressure bandage is not a tourniquet and will not stop blood flow. Instead it compresses the lymph system (which takes up the venom first before it enters the blood system) therefore lessening the spread of it through the body. However take note that this treatment is only effective for elapid bites (cobras, mambas, etc.). Do not use it for viper (puff adder, etc.) or Mozambique spitting cobra bites, because a side-effect of these snakes’ venom is tissue swelling and to place a constrictive bandage on a swelling limb will only result in even more serious tissue damage.
Apply the pressure bandage (or improvise with strips of clothing) to the site of the bite, and wind it upwards towards the armpit or groin (or as high as possible). Remember, a pressure bandage is NOT a tourniquet and the pressure should be similar to that of strapping a sprained ankle. To check that it is not too tight, test for an arterial pulse above and below the bandage. Keep the limb as immobile as possible at all times. Bandage an arm in a bent position so as to allow a splint to be applied to the forearm which can then be placed in a sling. The leg should also be splinted. Forget about trying to remove clothing, bandage over these, time is of the essence.
Where difficulty in breathing occurs, administer artificial res- piration. Don’t forget, the venom from elapid snakes (mambas and cobras) will cause paralysis of the diaphragm so the victim will experience difficulty in breathing.
WHAT ABOUT FIRST AID FOR VIPER BITES?
Unfortunately if you are in a remote area and have to deal with a viper bite (the venom works by breaking down tissue) there is little you can do other than to cover the wound with a loose, sterile bandage and keeping the victim calm while getting him to a medical facility as soon as possible. Contrary to misconceptions you won’t drop dead straight away. Depending on where you were bitten and the amount of venom injected, you will have more than enough time to seek medical attention. If you are on your own, walk out slowly but if you are with others have them carry you. Although venom is first taken up into the lymph system, you need to limit its movement around the body by limiting physical movement which will elevate the heart rate.
TREATMENT OF VENOM IN THE EYES
Receiving a dose of venom to the eyes from a spitting cobra is extremely painful and I speak from experience. The eyes should immediately be flushed with any cool liquid at hand; water, milk, cola, beer, cold tea, even urine can be used. Avoid the temptation to rub the eyes as this can rub the venom into the eyeball where it will cause more serious problems such as ulceration. And should you break a capillary it could enter the blood system and manifest as though you had been bitten by the snake.
The victim should then be placed in the shade with a cold compress covering his eyes as they will be extremely sensitive to sunlight. Although the eyelids will become red, swollen and difficult to open, they will return to normal within 24 hours providing that the venom has been flushed out. For safety reasons, a medical check-up should be sought.
USING ANTIVENOM
Although commercial over-thecounter snakebite kits are available at pharmacies, administering antivenom is extremely hazardous. An allergic reaction leading to anaphylactic shock is a very real possibility. Most snakebite kits contain a polyvalent antivenom which covers a range of species. Unless you are in the deepest depths of Africa, days away from a hospital, and are sure it was a venomous snake responsible for the bite, leave antivenom treatment to properly trained medical staff.
TAIL-END
Although a snakebite is a frightening experience (I can attest to that, having been bitten once by a puff adder), it is comforting to know that with proper first aid and prompt medical treatment, there is a more than good chance of recovery. Though some disfigurement, or the odd finger loss may result from a viper bite.
ABOUT THE AUTHOR
Paul Donovan is an outdoor activity instructor and biologist living in Botswana where he teaches bushcraft and survival techniques. * DISCLAIMER: Neither the author nor publisher are liable for damage or injury sustained in using any of the above practices.