Snake Bites: and Their Treatment

SNAKE BITES
And their treatment

By
HMC(FMF) Thomas Mendenhall
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SNAKE BITES

SNAKE BITES
Common names: Gaboon viper, butterfly adder, forest puff adder, swampjack,[2]
(more).
Bitis gabonica is a venomous viper species found in the rainforests and savannas
of Sub-Saharan Africa.[1] This is not only the largest member of the genus Bitis,[3] but
also the world's heaviest viperid[2] and it has the longest fangs and the highest
venom yield of any venomous snake.[2] Two subspecies are currently recognized,
including the nominate race described here.[

SNAKE BITES
According to the paper titled “"The Global Burden of Snakebite: A Literature Analysis
and Modelling Based on Regional Estimates of Envenoming and Deaths
Each year tens of thousands of people die from snake bites, [
The outcome of snake bites depends on numerous factors, including the

species of snake, the area of the body bitten, the amount of venom
injected, and the health conditions of the victim. Symptoms common to
all bites, such as terror and tachycardia, are psychological and caused by
the victim's panic.[2][3] Bites from non-venomous snakes can also cause
injury, often due to lacerations caused by the snake's fangs, or from a
resulting infection. A bite may also trigger an anaphylactic reaction,
which is potentially fatal.

SNAKE BITES
Dry snakebites, and those inflicted by a non-venomous species, can still cause
severe injury to the victim. There are several reasons for this: a snakebite which is
not treated properly may become infected (as is often reported by the victims of
viper bites whose fangs are capable of inflicting deep puncture wounds), the bite
may cause anaphylaxis in certain people, and the snake's saliva and fangs may
harbor many dangerous microbial contaminants, including Clostridium tetani. If
neglected, an infection may spread and potentially kill the victim.
the percentage of dry bites varies between species; 50% of bites from the
normally timid coral snake do not result in envenomation, whereas only 25%
of pitviper bites are dry
Most snakebites, whether by a venomous snake or not, will have some type of
local effect. There is minor pain and redness in over 90% of cases, although this
varies depending on the site

SNAKE BITES
Bites by vipers and some cobras may be extremely painful, with the local
tissue sometimes becoming tender and severely swollen within 5 minutes.[5]
This area may also bleed and blister
Symptoms may become more life-threatening over time, developing into

hypotension, tachypnea, severe tachycardia, altered sensorium, and
respiratory failure.
Venom emitted from elapids, including cobras, kraits, mambas, sea snakes,
and many Australian species, contain toxins which attack the nervous
system, causing neurotoxicity.[5][2][10] The victim may present with strange
disturbances to their vision, including blurriness. Paresthesia throughout the
body, as well as difficulty speaking and breathing may be reported. [2]
Nervous system problems will cause a huge array of symptoms, and those
provided here are not exhaustive. If the victim is not treated immediately
they may die from respiratory failure. Return to Turnover Document
SNAKE BITES
While most snakes must open their mouths before biting, African and Middle
Eastern snakes belonging to the family Atractaspididae are able to fold their
fangs to the side of their head without opening their mouth and jab at victims

SNAKE BITES
DO NOT
Do NOT allow the person to become over-exerted. If necessary,

carry the person to safety.
Do NOT apply a tourniquet.
Do NOT apply cold compresses to a snake bite.
Do NOT cut into a snake bite with a knife or razor.
Do NOT try to suck out the venom by mouth.
Do NOT give the person stimulants or pain medications unless a
doctor tells you to do so.
Do NOT give the person anything by mouth.
Do NOT raise the site of the bite above the level of the person's
heart.
SNAKE BITES
First Aid guidelines
1. Allow bite to bleed freely for 1-2 minutes.

2. Using a disinfectant thoroughly clean the wound if possible.
3. Apply hard direct pressure with gauze pad over
bite area.
4. Strap pad tightly in place with adhesive tape.
5. Remove tight clothings, shoes, watch or rings.
6. Keep affected extremity as close to heart level as
possible. affected part, if possible use a splint.
7. Immobilize
8. Give plenty of reassurance to the victim.
9. Transport to medical facility as quickly as possible.

SNAKE BITES
Anitvenom
Until the advent of antivenom, bites from some species of snake were almost
universally fatal.[29] Despite huge advances in emergency therapy, antivenom is often
still the only effective treatment for envenomation. The first antivenom was
developed in 1895 by French physician Albert Calmette for the treatment of
Indian cobra bites. Antivenom is made by injecting a small amount of venom into an
animal (usually a horse or sheep) to initiate an immune system response. The resulting
antibodies are then harvested from the animal's blood.
Antivenom is injected into the patient intravenously, and works by binding to and
neutralizing venom enzymes. It cannot undue damage already caused by venom, so
antivenom treatment should be sought as soon as possible. Modern antivenoms are
usually polyvalent, making them effective against the venom of numerous snake
species. Pharmaceutical companies which produce antivenom target their products
against the species native to a particular area. Although some people may develop
serious adverse reactions to antivenom, such as anaphylaxis, in emergency situations
this is usually treatable and preferred over the potential consequences of not using
antivenom.
SNAKE BITES
SNAKE VENOM ANTISERUM AFRICAN
ASNA ANTIVENOM C
Click to go to manufacturer’s instruction sheet
DOSAGE:
Initial dose depends upon an estimate of the quantity of envenomation as mentioned
below:
1. Minimal Envenomation- Progressive local swelling but no systemic symp-toms. 5
vials of 10ml (50ml) are recommended to be administered.
2. Moderate Envenomation- Swelling beyond the site of the bite, mild systemic
symptoms, and /or hematological and coagulation abnormalities are present. 5 to 10
vials (50 to 100ml) as recommended to be administered.
3. Severe Envenomation- Rapidly progressive and extensive local effect, sys-temic

symptoms and evidence of hemolysis or coagulopathy. 10 to 20 vials (100-200ml)
or more is recommended to be administered.
In children and small adults (body weight less than 40kg) upto 50% more doses of
Snake Venom Antiserum is recommended to be administered.
SNAKE BITES
SNAKE VENOM ANTISERUM AFRICAN
ASNA ANTIVENOM C
Click to go to manufacturer’s instruction sheet
Administration:
Snake Venom Antiserum is administered intravenously either undiluted at

the rate of not more than 1ml per minute or is diluted in 500ml of
intravenous fluid (either Sodium Chloride Injection or 5% Dextrose
Injection) and administered as rapidly as tolerated over 1-2 hours. While
diluting the Snake Venom Antiserum, mix by gentle swirling rather than
shaking to avoid foaming.
Additional infusions should be repeated hourly until progressive swelling in

the bitten part ceases and systemic signs and symptoms disappear. When an
adequate dosage is achieved, the improvement in patient’s clinical signs is
often seen.
SNAKE BITES
Snakes are likely to approach residential areas

when attracted by prey, such as rodents.
Practicing regular pest control can reduce the
threat of snakes considerably. It is beneficial to
know the species of snake that are common in
local areas, or while traveling or hiking. Areas of
the world such as Africa, Australia, the
Neotropics, and southern Asia are inhabited by
many highly dangerous species. Being wary of
snake presence and ultimately avoiding it when
known is strongly recommended. Return to Turnover Document
SNAKE BITES

SNAKE BITES
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SNAKE BITES

And their treatment

Return to Turnover Document

Return to Turnover Document

Return to Turnover Document

Each year tens of thousands of people die from snake bites, [

The outcome of snake bites depends on numerous factors, including the

Return to Turnover Document

Return to Turnover Document

Symptoms may become more life-threatening over time, developing into

Return to Turnover Document

Do NOT allow the person to become over-exerted. If necessary,

1. Allow bite to bleed freely for 1-2 minutes.

Return to Turnover Document

3. Severe Envenomation- Rapidly progressive and extensive local effect, sys-temic

Snake Venom Antiserum is administered intravenously either undiluted at

Additional infusions should be repeated hourly until progressive swelling in

Snakes are likely to approach residential areas

Return to Turnover Document

Return to Turnover Document

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