First Aid for Snakebite

[Snakes Incorporated]

QUICK_EDIT Attach signature (signatures can be changed in profile) close

First Aid for Snakebite
• Keep the patient still and reassure them.
• Maintain vital functions, if imperilled (e.g. "ABC")
• Immediately apply a pressure immobilisation bandage.
• Try and maintain the patient as still as possible and bring transport to them.
• Always seek medical help at the earliest opportunity.
• If the snake has been killed, bring it with the patient, but do not waste time, risk further bites and delay application of pressure bandage and splint by trying to kill the snake.
• Do not wash the wound.
• Do not use a tourniquet.
• Do not cut or suck the wound.
• Do not give alcohol to the patient.
• Do not give food and only non-alcoholic clear fluids may be used for drinks.



Basic Principles
There are several important principles of first aid for bites and stings that should guide decisions on what is, and as importantly, what is not good first aid.
· First aid should do no harm!
· First aid should be practical and achievable.
· First aid should be supported by both clinical and scientific evidence of effectiveness.
Older "first aid" methods for snakebite are classic examples of techniques with the potential to cause the patient harm. Indeed, the use of tourniquets and "cut and suck" have resulted in numerous cases of permanent and severe injury to patients, even deaths.


The Pressure Immobilisation Method
This important first aid method was developed by Dr. Struan Sutherland and colleagues at CSL and first published in 1978 in the prestigious international journal, "The Lancet". It is based on knowledge of the structure of important snake and spider toxins and previous clinical and experimental experience. It has been known for many years that the lymphatic system plays a key role in transport of toxins from the periphery to the circulation. In the case of snake venom toxins this is easily explained by the large size of these toxins. Clinically, adenopathy in nodes draining the bite site is often an early sign of absorption of venom, and in those tragic cases ending fatally, Sutherland was able to show high concentrations of venom in regional nodes.
The aim of this method is therefore to retard venom transport via the lymphatic system. This is achieved in a dual approach. Firstly the lymphatic vessels at the bite site are compressed by bandaging, extended to much of the rest of the bitten limb as possible. Secondly, proximal movement of lymph in the vessels is slowed or stopped by splinting the limb, thus also stopping the "muscle pump" effect of muscle movement. Correctly applied, this technique can virtually stop venom movement into the circulation until removed, up to hours later, without any threat to limb tissue oxygenation, which is just one of the major problems in using tourniquets. It must be remembered, however, that this method is only first aid. It is not definitive medical treatment for envenoming. Once in a hospital equipped to treat the bite with antivenom, if necessary, then all first aid should be removed after initial tests and precautions are taken. The details of these may be found in the following section on "Medical Treatment of Bites and Stings".
In summary, the pressure immobilisation method of first aid is:
• Apply a firm broad bandage or similar (even clothing strips or pantyhose will do in an emergency) over the bite site, at the same pressure as for a sprain. Do not occlude the circulation.
• Apply further bandage over as much of the rest of the bitten limb as practical. Ensure fingers or toes are covered to immobilise them. It is often easiest to go over the top of clothing such as jeans, rather than move the limb to remove clothing.
• Ensure the bitten limb is kept motionless by applying a splint and instructing the patient to cease all use of the limb and any general activity.
The pressure immobilisation method of first aid is ideal for Australian snakebite by all species, as well as bites from suspected funnel web spiders and mouse spiders, and for bites by the blue ringed octopus and cone. It is not appropriate for bites from the red back spider, other spiders, scorpions or centipedes or stings from venomous fish.

[Snakes Incorporated]

QUICK_EDIT Attach signature (signatures can be changed in profile) close

General Rules on Snakebite Treatment

Bela Demeter, a biologist with the department of herpetology at the Smithsonian Institution's National Zoological Park in Washington, D.C.: "It's best not to do a whole lot. If you have not done first aid on a snake bite, then you haven't done anything wrong yet."
General Rules on Snakebite Treatment
by Dr. John L. Kiel
1. The best first aid is immobilization of the patient and the affected part (splinting, direct pressure, compression over bite).
2. Do not use tourniquets.
3. Incision and suction of wound is ineffectual in removing venom 30 minutes after the bite.
4. Wash skin.
5. Coral snake bite shows little local reaction; may see anesthesia euphoria; patients observed up to 48 hours for respiratory and cardiac abnormalities.
6. Remember antivenin is a horse serum immunoglobin and may cause anaphylaxis-sensitivity test; note history of allergies and hypersensitivites.
7. Polyvalent antivenin (crotalidae) is not effective against coral snake venom; only effective against rattlesnakes, copperheads, and cottonmouths. A separate coral snake antivenin is available (Wyeth).
8. I. V. is the best route for antivenin (may be given in sodium chloride or 5% dextrose).
9. The longer one waits the more damage from snake venom.
a. Up to 4 hours after bite antivenin is very effective.
b. 4 - 8 hours, less effective.
c. 12 hours, questionable value.
10. More severe the envenomation, the more antivenin.
11. Smaller the patient, the larger the snake, the more antivenin.
Up to 90% of patients develop serum sickness from antivenin in 5 - 24 days: malaise, fever, urticaria, edema, nausea, vomiting, lymphadenopathy, and arthralgia