Snakebite

Snakebite (drink)

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The symptoms that result from the bite of a venomous snake will depend on the type of snake involved. Some common reactions include the following:. Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Snake Bites It is best to treat all snake bites as a medical emergency unless one is certain the bite came from a non-venomous snake.

Types of snake bites and do's and don'ts to treat bites are included. Overview Management and Treatment Prevention. What are snake bites? In general, the major categories of venom are: Cause swelling and tissue damage in the area of the bite. Cause disruption to blood vessels. Prevent the blood from clotting. Cause paralysis or other damage to the nervous system. Viper and elapid venom can cause direct myocardial damage manifesting as arrhythmias, bradycardia, tachycardia or hypotension.

Renal failure is secondary to ischaemia in Viper bites especially Russell's viper. A variety of factors contribute to shock. They include fright, hypovolemia due to extravasation of fluids and blood loss , myocardial depression, haemorrhage into the adrenals and pituitary and increased kinin production as in Viper bite.

The patient should be reassured and moved to the nearest hospital as quickly as possible. Active movements should be as minimal as possible. The bitten part should be immobilized with a splint or sling. Tourniquets and compression bandages are potentially dangerous as they can cause gangrene, increased fibrinolysis and bleeding in the occluded limb, peripheral nerve palsies and intensification of local envenomation. The only indication for their use is in case of severe elapid or sea snake bites where the delay in reaching a medical centre is likely to be more than 0.

Tourniquet should be tight enough to occlude the lymphatic and venous flow but not the arterial flow. A useful guide is that it should be loose enough to permit a finger to slip under it. The tourniquet should be released for 30 seconds every 15 minutes to allow slow release of venom into circulation, thereby enabling its neutralization. The tourniquet should only be released after the first dose of antivenom is given [ 4 ]. The bite wound should be gently wiped with sterile cotton gauze.

In case of incoagulable blood or oozing from puncture wounds only use the intravenous route for medication. A bite is considered to have been poisonous in case any of the following features are present:. Monitor pulse, blood pressure, respiratory rate, and muscle weakness hourly.

Local swelling and necrosis should also be charted hourly.

Clinical Features And Management Of Snake Bite

Examine gingival sulci carefully for bleeding. Serum electrolytes, especially potassium, should be estimated 6 hourly in case of sea snakebite.

Coagulation profile should be tested 6 hourly especially for viper bites. A useful test for venom-induced defibrinogenation is the minute whole blood clotting time.

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A few milliliters of venous blood is put in a clean test tube and kept aside for 20 minutes. It is then tipped to see if it has clotted or not. Incoagulability indicates systemic envenomation by Vipera or Echis species. Other sensitive tests are plasma prothrombin time and fibrinogen degradation product estimation. Platelet count should be estimated twice daily.

Urine should be examined for microscopic haematuria and active sediments. Output should be monitored in case of renal failure. The most important decision in managing a case of snakebite is to decide whether to administer antivenom or not. There is evidence that in patients with severe envenomation, the benefits of this therapy far outweigh the risk of reactions [ 1 ].

General indications for antivenom administration are:. Haemostatic abnormalities such as spontaneous systemic bleeding, incoagulable blood, or thrombo-cytopaenia. In the absence of systemic envenoming, local swelling involving more than half the bitten limb, extensive blistering or bruising, bites on digits or rapid progression of swelling.

Supportive laboratory evidence of systemic envenoming even in the absence of clinical signs. It is almost never too late to give anti-venom as long as systemic signs of envenoming persist. Antivenom has been shown to be effective up to 2 days after sea snake bite and in patients still defibrinated weeks after viper bite. The anti-venom available in the Armed Forces is a polyvalent equine antiserum. This is effective against the 4 most important venomous snakes in India, namely, Cobra, Common Krait, Russell's viper and saw-scaled viper.

The antiserum is available in a lyophilized form and has to be reconstituted with 10 ml sterile water for injection. The dose required depends on the clinical state. The dose requirement for viper bite is as follows:. Higher doses are indicated for elapid bites because elapid venom is less antigenic and also more rapidly absorbed. An initial dose of - ml is given. The dose is same for adults and children.

Response to antivenom is dramatic and rapid. Until the advent of antivenom , bites from some species of snake were almost universally fatal.

Clinical Features of snakebite

The first antivenom was developed in by French physician Albert Calmette for the treatment of Indian cobra bites. Antivenom is made by injecting a small amount of venom into an animal usually a horse or sheep to initiate an immune system response. The resulting antibodies are then harvested from the animal's blood. Antivenom is injected into the person intravenously , and works by binding to and neutralizing venom enzymes. It cannot undo damage already caused by venom, so antivenom treatment should be sought as soon as possible. Modern antivenoms are usually polyvalent, making them effective against the venom of numerous snake species.

Pharmaceutical companies which produce antivenom target their products against the species native to a particular area. Although some people may develop serious adverse reactions to antivenom, such as anaphylaxis , in emergency situations this is usually treatable and hence the benefit outweighs the potential consequences of not using antivenom. Giving adrenaline epinephrine to prevent adverse effect to antivenom before they occur might be reasonable where they occur commonly. The following treatments, while once recommended, are considered of no use or harmful, including tourniquets, incisions, suction, application of cold, and application of electricity.

In extreme cases, in remote areas, all of these misguided attempts at treatment have resulted in injuries far worse than an otherwise mild to moderate snakebite. In worst-case scenarios, thoroughly constricting tourniquets have been applied to bitten limbs, completely shutting off blood flow to the area.

By the time the person finally reached appropriate medical facilities their limbs had to be amputated. Estimates vary from 1. Most snakebites are caused by non-venomous snakes. Worldwide, snakebites occur most frequently in the summer season when snakes are active and humans are outdoors. Snakes were both revered and worshipped and feared by early civilizations. The ancient Egyptians recorded prescribed treatments for snakebites as early as the Thirteenth Dynasty in the Brooklyn Papyrus , which includes at least seven venomous species common to the region today, such as the horned vipers.

The object was regarded as a divinely empowered instrument of God that could bring healing to Jews bitten by venomous snakes while they were wandering in the desert after their exodus from Egypt. Healing came about by merely looking at the object as it was held up by Moses. Historically, snakebites were seen as a means of execution in some cultures. In medieval Europe , a form of capital punishment was to throw people into snake pits , leaving people to die from multiple venomous bites.

Snakebite as a surreptitious form of murder has been featured in stories such as Sir Arthur Conan Doyle 's The Adventure of the Speckled Band , but actual occurrences are virtually unheard of, with only a few documented cases. At least one attempted suicide by snakebite has been documented in medical literature involving a puff adder bite to the hand. Several animals acquired immunity against venom of snakes that occur in the same habitat. From Wikipedia, the free encyclopedia.

For other uses, see Snakebite disambiguation. List of dangerous snakes. Map showing the approximate world distribution of snakes. Map showing the global distribution of snakebite morbidity. National Institute for Occupational Safety and Health. Archived from the original on 29 April Retrieved 19 May Barish 1 April The New England Journal of Medicine. Archived from the original on 4 May Archived from the original on 30 September Archived from the original on 21 May World Report on Child Injury Prevention.

Archived from the original on 2 February Archived from the original on 18 April Retrieved 16 May Scientific, Technological and Public Health Considerations". Bulletin of the World Health Organization. A Comprehensive Study Guide. Review provided by VeriMed Healthcare Network. A study of 39 victims".

Archived from the original on 7 October Retrieved 5 September The ringhals cobra Hemachatus haemachatus Venom-Induced corneal opacification syndrome". David G; Warrell, David A The Need for a Global Partnership". Archived PDF from the original on 28 April Retrieved 24 July Neuroparasitology and tropical neurology. Archived from the original on 8 September The Journal of Experimental Biology.

Snake venom

Archived PDF from the original on 9 January Archived from the original on 7 January Zoological Journal of the Linnean Society. Archived PDF from the original on 10 October Retrieved 25 July Archived from the original PDF on 30 May Retrieved 18 September Annual Review of Medicine. The Dangerous Snakes of Africa. Archived from the original PDF on 25 April Retrieved 25 October Journal of Family Practice.

Current concepts in diagnosis, treatment, and management". Emerg Med Clin North Am.

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