Health: Prevention

Often More Alarming Than Dangerous…

Contrary to popular belief, there is no venom capable of causing death within mere minutes. The only immediate serious risk following a snake bite is anaphylactic shock, which is a severe allergic reaction and not due to the venom’s toxicity. This shock can also occur from a wasp sting or even eating strawberries. Snake venoms are meant to neutralize prey and initiate pre-digestion.

The toxicity of venom is dose-dependent. The more venom injected, the more toxic it becomes. This explains the low mortality rate in human bites (venom glands may not be full at the time of the bite, and venom ducts may not empty completely).

Enzymatic or Hemotoxic Venom

This type causes necrosis around the bite area, which can spread. The bite is very painful, with significant swelling, and the area turns purplish and hemorrhagic. Without treatment, gangrene and secondary infection can set in. Early treatment limits the necrotic area. This type of envenomation is rarely fatal but is very painful.

Neurotoxic Venom

This paralytic toxin is similar to curare. Paralysis begins within one to three hours, starting with the striated muscles and progressing to the eyelids, swallowing muscles, and eventually respiratory muscles. Treatment involves respiratory support in intensive care to get through the critical phase. Without treatment, the victim may die from asphyxiation. Other symptoms include visual disturbances, hypersalivation, tearing, sweating, increased digestive motility (diarrhea, vomiting), slow heart rate, and behavioral disturbances such as agitation or drowsiness.

Mixed Venom

These cases are the most severe, combining neurotoxic and hemotoxic effects. The clinical picture is dominated by pain and the risk of respiratory paralysis, which can be fatal within hours.

The main principle is to do everything to slow the spread of the venom. Here’s what to do:

Stay Calm: Snake bites are rarely fatal, and the immediate urgency is relative. Venom takes hours to act.

Avoid Running: Running increases heart rate.

Lay the Victim Down: Keep them at rest.

Do Not Apply a Tourniquet: It’s unnecessary and dangerous.

Do Not Suck the Venom: Using your mouth is ineffective and dangerous.

Do Not Incise the Wound: This can aid venom spread.

Identify the Snake if Possible: Without unnecessary risk, identifying the snake helps determine the appropriate treatment.
Clean the Wound: Use soap and an antiseptic like hydrogen peroxide, Betadine, or Dakin. Avoid alcohol or ether, which are ineffective and can promote venom spread.

Remove Restraints: Remove rings, bracelets, watches, and anything that could restrict blood flow as swelling increases.

Apply a Loose Bandage: If possible, use a crepe bandage to limit lymphatic circulation without cutting off blood flow. Ensure a finger can fit between the bandage and skin; it’s not meant to be a tourniquet.
Immobilize the Limb: Use a sling for an upper limb, with the elbow at a right angle. For a lower limb, use an improvised splint.

Alleviate Pain: Use paracetamol-based painkillers. Avoid aspirin derivatives and anti-inflammatories due to bleeding risk. If available, ice wrapped in a cloth can reduce pain and swelling.

Reduce Anxiety: Use anxiolytics if necessary.
Avoid Alcohol, Coffee, and Tea: These increase heart rate and promote venom spread.

Do Not Use Heat: Applying something hot like a cigarette near the bite is ineffective.
Evacuate the Victim: Get them safely to medical care.

If Immediate Medical Care is Possible:

Establish a Venous Line: For fluid administration.
Treat Shock: Provide the necessary medical support.
Injectable Paracetamol: For pain management.
Antibiotics: To prevent secondary infection.

Important Notes:

– Do not inject antivenom outside of a hospital. It carries a risk of allergic reactions.
– Corticosteroids and anticoagulants are not recommended pre-hospital.
– Not all snake bites result in envenomation. Pain is not an indicator of severity, and envenomation is dose-dependent.
– Venom is injected deep; hence, venom extractors are mostly ineffective. While not harmful, they mainly provide reassurance to the victim.

Snake bites often cause more alarm than danger. Knowing what to do can drastically reduce risks and ensure the best possible outcome until professional medical help is available.