WILDSIDE

ZIMBABWE

SNAKE BITES

Symptoms

Snakebite symptoms vary dramatically from bite to bite. Many snakebites take place so quickly that victims are not always certain that they have actually been bitten. A bite mark is seldom the characteristic two-fang puncture mark – often a bite will be from a single fang and may just be a scratch with a little bleeding.

 

In the event of a snakebite, the victim may have some of the following symptoms

  • An immediate burning pain, followed by swelling, which progresses up the limb and may affect the lymph glands (the Puff Adder and the Mozambique Spitting Cobra).
  • Dizziness, difficulty in swallowing and breathing, drooping eyelids and nausea (the mambas and the Cape Cobra).
  • Bleeding from the nose, small cuts, followed by bleeding from the mucous membranes and, after several hours, and severe internal bleeding (the Boomslang and the Twig Snake).
  • Shock, which can cause nausea, pain and difficulty in breathing.

 

In the Event of A Snakebite DO NOT…

  • DO NOT try to cut or suck out the venom
  • Snake venom very quickly attaches to local tissue and is absorbed into the lymphatic system and very little venom can be removed by suction. Cutting may expose the wound to secondary infection.
  • DO NOT apply any electric shock therapy
  • Electric shocks do not neutralise snake venom.
  • DO NOT apply a tourniquet
  • Arterial or venous tourniquets are not advised in most bites as venom is initially transported largely through the lymphatic system and not through veins. There is little evidence that a tourniquet could be life-saving following a snakebite.
  • DO NOT apply ice or boiling water, lotion or potions
  • Leave the bite site alone, except for cleaning it with cool water and applying a sterile gauze dressing. Boiling water does not denature snake venom. Do not give the victim alcohol.
  • DO NOT inject antivenom as a first aid measure

 

If required, antivenom must be injected intravenously by a medical doctor in a hospital environment and usually in large quantities. Some patients have an allergic reaction to antivenom and this may result in anaphylaxis – a life-threatening condition if not treated promptly.

 

First Aid Measures for Snakebite

  • Get the victim to a hospital as soon as possible and in a safe manner
  • Keep the number of the closest hospital (with a trauma unit) and ambulance service on your cell phone and call ahead to notify them of the emergency. The navigational App Waze is very handy – type in ‘hospital’ or ‘doctor’ and the closest facilities will be listed immediately and with details. (Download the ASI Snakes app)
  • Keep the victim calm and as still as possible
  • Movement speeds up the spread of venom in the lymphatic system. Immobilise the victim, lay the victim down if possible and transport (or arrange transport) to the closest hospital. Elevate the affected limb slightly above heart level.
  • Remove rings and tight clothing
  • If bitten on the hand, arm, foot, or lower leg, remove rings, bangles, bracelets, watches, anklets and any other tight jewellery, as well as tight clothing and shoes.
  • Apply pressure bandages
  • If you are more than an hour or two from the closest medical facility, consider applying pressure bandages to the affected limb, but only in suspected Black Mamba or Cape Cobra bites. Please see section on Smart Bandages.

 

IMPORTANT  Do not waste valuable time applying a pressure bandage – immediately transport the patient to the nearest hospital with a trauma unit and, if possible, apply the pressure bandage whilst travelling.

 

Pressure Bandages

Pressure immobilisation may be beneficial and inhibit the spread of venom while the victim is transported to hospital. It should not be used in spitting cobra or adder bites where excessive swelling is anticipated, but rather for bites from the Cape Cobra and Black Mamba. The idea is not to slow down blood flow, but rather to put pressure on the lymphatic system and, in doing so, reduce the rate at which venom is absorbed.

 

The application of a pressure bandage is rather complex and requires training to get the pressure right. Ideally make use of a Smart bandage.

 

Application of a Pressure Bandage

  • Immobilise the limb and immediately apply firm pressure to the site of the bite with a hand.
  • Wrap the bite site tightly with a Smart bandage and continue wrapping the entire limb from the bite towards the heart.
  • For the pressure bandage to be most effective, it must be applied at a very specific pressure – 50 -70 mmHg on a blood pressure monitor. This is easily achieved with a Smart bandage and near impossible with a regular crepe bandage.
  • This is not easily achieved without proper training but, as already mentioned, it is unlikely to cause any ill effects in Black Mamba or Cape Cobra bites.
  • For bites on the foot or leg, once the pressure bandage has been applied properly, splint the leg to immobilise it and bind the two legs together to maximise immobilisation.
  • If the bite is on a hand, straighten the arm and, once the immobilisation bandages have been applied, splint the straightened arm to immobilise it. After applying the pressure bandage, check for the presence of a pulse below distal to the bandage. Check the pulse every 10-15 minutes. If the pulse is not palpable, then the pressure bandage should be removed and the need for it reassessed.
  • Provided there is no contraindication to it staying in place, the pressure bandages should remain in place until such time as the patient reaches a hospital and must only then be removed by a medical doctor.

 

REF: CFUZIM - www.cfuzim.com