Treatment for SNAKE BITES
Writers and medical researchers have debated the first aid treatment of snakebite for a long time. Major areas of controversy have been over the use of tourniquets, incision and suction to remove the venom, and the use of ice. It is clear that very significant amounts of venom can be removed by incision and suction, more than fifty percent and sometimes as much as ninety percent of the total injected.6 This procedure is much less valuable if begun thirty minutes or more after the bite and should not be used if more than sixty minutes have elapsed since the bite.
Tourniquets, incision, and suction are not used for coral snake bites. The wound should be washed immediately and the victim taken to a hospital.
One of the prime goals in handling a snakebite victim is for everyone involved to keep calm. Physical activity on the part of the victim may result in faster spread of the venom throughout his system. -Efforts should be made to kill or at least identify the offending serpent, though not at the risk of further bites. Physicians often see near-hysterical persons who have been bitten by snakes that were not poisonous. It is much easier to reassure these individuals if the snake is available for identification.
If tourniquets are to be used, they should be applied above the next joint or two to four inches above the bite. The tourniquet should fit snugly, but remain loose enough to allow a finger to be slipped beneath it. It must not cut off the pulse beyond it. The tourniquet should be released for about ninety seconds every ten to fifteen minutes and moved towards the body to keep it just ahead of the swelling. Tourniquets should probably not be used if they cannot be applied within thirty minutes of the bite and should not be continued for more than two hours.
Incisions are made with a sharp blade, such as a razor or sharp knife that has been sterilized with heat or alcohol. The incisions should be 1/8 to 1/4 inch long and about 1/8 inch deep through each fang mark. The incisions are made no more than skin deep. When making the incision, it is very helpful to pinch the skin between 'the thumb and forefinger and pull this fold of skin upward and away from the surface of the extremity. This allows careful control of the depth of the incision and helps avoid cutting too deeply into underlying tendons or blood vessels. Suction is then begun and continued for one hour or until antivenin is administered. Commercially available suction cups are much better than oral suction because the latter contaminates the wound with germs from the mouth. Oral suction should not be attempted if there are cuts or sores in the mouth.
If the bite is on an arm or leg (almost all are), the limb should be gently immobilized with a splint and kept at a level below the heart but not hanging downward. Ice bags have been suggested, mainly to control pain, but should be avoided; excessive cooling will increase damage to the tissues and blood vessels and can cause loss of the limb.
Obviously, the victim should be transported to the nearest medical facility immediately. In severe bites antivenin may be lifesaving, but allergic reaction to it is common. The quantity given depends on the severity and circumstances of the bite, size and species of the snake, and size and, health of the victim. Possible complications, other than direct results of the venom, include a secondary infection of the wound, tetanus, reactions to the antivenin, and amputations necessitated by the overzealous use of ice.
In summary, the following measures should be taken in the case of snakebite:
Tourniquets, incision, and suction are not used for coral snake bites. The wound should be washed immediately and the victim taken to a hospital.
One of the prime goals in handling a snakebite victim is for everyone involved to keep calm. Physical activity on the part of the victim may result in faster spread of the venom throughout his system. -Efforts should be made to kill or at least identify the offending serpent, though not at the risk of further bites. Physicians often see near-hysterical persons who have been bitten by snakes that were not poisonous. It is much easier to reassure these individuals if the snake is available for identification.
If tourniquets are to be used, they should be applied above the next joint or two to four inches above the bite. The tourniquet should fit snugly, but remain loose enough to allow a finger to be slipped beneath it. It must not cut off the pulse beyond it. The tourniquet should be released for about ninety seconds every ten to fifteen minutes and moved towards the body to keep it just ahead of the swelling. Tourniquets should probably not be used if they cannot be applied within thirty minutes of the bite and should not be continued for more than two hours.
Incisions are made with a sharp blade, such as a razor or sharp knife that has been sterilized with heat or alcohol. The incisions should be 1/8 to 1/4 inch long and about 1/8 inch deep through each fang mark. The incisions are made no more than skin deep. When making the incision, it is very helpful to pinch the skin between 'the thumb and forefinger and pull this fold of skin upward and away from the surface of the extremity. This allows careful control of the depth of the incision and helps avoid cutting too deeply into underlying tendons or blood vessels. Suction is then begun and continued for one hour or until antivenin is administered. Commercially available suction cups are much better than oral suction because the latter contaminates the wound with germs from the mouth. Oral suction should not be attempted if there are cuts or sores in the mouth.
If the bite is on an arm or leg (almost all are), the limb should be gently immobilized with a splint and kept at a level below the heart but not hanging downward. Ice bags have been suggested, mainly to control pain, but should be avoided; excessive cooling will increase damage to the tissues and blood vessels and can cause loss of the limb.
Obviously, the victim should be transported to the nearest medical facility immediately. In severe bites antivenin may be lifesaving, but allergic reaction to it is common. The quantity given depends on the severity and circumstances of the bite, size and species of the snake, and size and, health of the victim. Possible complications, other than direct results of the venom, include a secondary infection of the wound, tetanus, reactions to the antivenin, and amputations necessitated by the overzealous use of ice.
In summary, the following measures should be taken in the case of snakebite:
1. Don't Panic.
2. Kill or identify the snake, but not if it will be risky or time consuming.
3. Apply a tourniquet.
4. Begin incision and suction of the wound.
5. Immobilize the extremity.
6. Evacuate the victim to the nearest qu~1ified medical facility.
2. Kill or identify the snake, but not if it will be risky or time consuming.
3. Apply a tourniquet.
4. Begin incision and suction of the wound.
5. Immobilize the extremity.
6. Evacuate the victim to the nearest qu~1ified medical facility.
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