Bites, Snake Flashcards
Features
Most bites do not result in envenomation
tends to occur in;
- snake handlers or
- in circumstances where snake has a clear bite of the skin
First aid
Keep pt as still as possible.
Do not;
- wash
- cut or manipulate the wound
- apply ice or use a tourniquet.
Immediately bandage the bite site firmly (not too tightly).
- A wide crepe bandage is ideal
- it should extend above the bite site for as high as possible, at least 15 cm
- e.g. if bitten around the ankle, the bandage should cover the leg to above the knee
- bandage can be cautiously removed when pt is safely under medical observation.
Splint the limb to immobilise it: a firm stick or slab of wood would be ideal.
Transport to a medical facility for definite treatment.
Do not give alcoholic beverages or stimulants.
A venom detection kit can be used to examine;
- a swab of the bitten area or
- a fresh urine specimen (the best) or
- blood
Observe for symptoms and signs of envenomation.
Envenomation
Important early symptoms of snake bite envenomation include:
- nausea and vomiting (a reliable early symptom)
- abdominal pain
- excessive perspiration
- severe headache
- blurred vision
- difficulty speaking or swallowing
- coagulation defects (e.g. haematuria)
- tender lymphadenopathy
The greatest danger is;
- respiratory obstruction
- failure or catastrophic bleeding.
Do not give antivenom unless:
- linical signs of envenomation or
- biochemical signs;
- positive urine, or
- abnormal clotting profile
Treatment of envenomation
Monitor vital signs.
Set up a slow IV infusion of N saline.
Dilute the specific antivenom (1 in 10 in N saline) and infuse slowly over 30 mins via the tubing of the saline solution (may need 2 or more ampoules of antivenom).
Have on standby:
- adrenaline
- antihistamines
- oxygen
- steroids
Provide basic life support as necessary.
A test dose of antivenom is not recommended.
Be careful of prophylactic adrenaline in some situations, e.g. avoid with brown snakes and with coagulopathy).
