FIRST AID in SNAKEBITE:

DO NOTS

• DO NOT INJECT ANTIVENOM. Unless you are hours away from a physician or medical facility anti-venom should not be injected by the layperson. Anti-venom is refined from horse serum and a percentage of people are highly allergic to it. Anaphylactic shock WILL kill your patient - whereas the patient stands a good chance of surviving the bite without anti-venom. Anti-venom is best left to the professionals in a proper facility where life-support systems are available. It should normally be unnecessary for the layperson to use anti-venom anywhere within the Peninsula.
   
• DO NOT CUT INTO THE BITE All you will probably do is assist the venom to spread more rapidly.
   
• DO NOT SUCK ON THE BITE If you have cuts in your mouth there will be two patients where there was one. If you have a suction device it may be applied or you can attempt sucking through a dental dam - should you have one handy.
   
• DO NOT APPLY ELECTRICAL SHOCK TO THE PATIENT A myth has grown up that application of shock or a stun gun is of assistance. This is a pure myth without any basis in fact whatsoever. You are more likely to kill than cure using this method.
   
• DO NOT GIVE DRUGS OR INTOXICANTS TO THE PATIENT Unless advised by a medical practitioner. Application of these substances make diagnosis far more difficult once you arrive at the hospital.
   
• DO NOT RUB TOPICAL SUBSTANCES INTO THE WOUND You may clean the wound with a little mild disinfectant and dress it lightly with something like Betadine ointment - but preferably leave it alone.
   
• DO NOT APPLY A TOURNIQUET You are likely to do far more damage with the tourniquet than without.
   
• DO NOT APPLY ICE OR HEAT TO THE WOUND Neither is of any use - but both may harm.
   

Shock - How to Recognise and Treat
 

Shock is a condition in which the circulatory system fails to circulate blood throughout the body properly. It is a progressive deteriorating condition that can be fatal. It is present to some degree in ALL physical trauma Shock CAN kill. The first indication that a person is going into shock is restlessness or irritability.
Some of the symptoms of shock are:

• Heavy or difficult breathing
• Rapid breathing
• Racing or Pounding heartbeat
• Rapid, weak pulse
• Excessive sweating
• Pale or bluish skin
• Excessive thirst
• Nausea, vomiting
• Drowsiness or unconsciousness.
   

Although it is impossible to care for shock by first-aid alone, you can take measures that could be life-saving. First-Aid Treatment for shock is:

• Reassure the victim and keep him/her calm. Help them rest comfortably (pain can intensify the body's stress, which accelerates shock).
• Have the victim lie down. Keeping them comfortable is the key.
• Keep your patient from becoming overheated or chilled. If a source of cold water is nearby, wet a cloth and wash their face regularly and lie them in the shade. If it is a cold day, wrap them in a blanket.
• If you sense that the victim is slipping into unconsciousness, take measures to prevent this from happening.
• Above all, keep the victim comfortable! Strike up a conversation with them and continue to reassure them.
• Once shock sets in, the victim's condition will continue to deteriorate, so getting help or getting the victim to help ASAP is the most important thing.
   

The first aid of choice, in snakebite, is the pressure bandage
 

The aim of the pressure bandage is to immobilise the limb and restrict the flow in the lymphatic system. This will slow the transport of the venom dramatically giving you the few hours extra to transport the patient to a well-equipped facility where medical practitioners can take over. A word of advice - many medical men have never seen or treated snakebite. It is fairly rare. Telephone your nearest Poison Centre, University or Snake Park. They usually are able to give advice on physicians with experience of handling snake envenomation. You may ask the treating physician to consult with such a person. Application of the pressure bandage: Get the victim to lie down immediately. Relax and reassure them. Keep calm yourself - you will have enough time. Talk soothingly and be confident. Using a crêpe bandage (or torn up strips of material) bandage the bitten limb. Start at the bite site and work upwards. Do not remove clothes as the movement required will assist the venom to spread. Wrap the limb as tightly as you would for a sprain. Firm, but do not cut off the blood supply. Apply a splint to the limb to immobilise it. Avoid massaging or rubbing the bite area. Do not remove the pressure bandage until medical personnel are ready to start treatment.

1. A VICTIM OF A PUFFADDER BITE TO THE ANKLE IS MADE TO LIE DOWN IMMEDIATELY 3. THE WIDE CREPE BANDAGE IS BOUND AS TIGHTLY AS FOR A SPRAIN 5. A SPLINT IS APPLIED TO THE PRESSURE-BANDAGED LIMB 7. THE LEG IS NOW COMPLETELY IMMOBILISED BY THE SPLINT

2. A PRESSURE BANDAGE, STARTING AT THE BITE SITE, IS BEGUN 4. THE BANDAGE IS TAKEN AS HIGH UP THE LIMB AS POSSIBLE 6. THE SPLINT IS BOUND TO THE LIMB SO AS TO IMMOBILISE IT COMPLETELY 8. THE PATIENT IS NOW READY TO BE TRANSPORTED TO A HOSPITAL

Some things to do

• Make a note of the time the bite occurred. This will help physicians to check on the progress of the venom.
• Remove constricting jewelry. Rapid swelling may make such items as rings and bracelets into objects of great pain.
• If possible phone ahead and clearly explain to the hospital that a possible snakebite case is on the way. If a positive identification of the snake can be made, make sure they know what to expect.
• Be prepared to render artificial respiration in the case of a cobra bite. A dangerous sign of impending lung paralysis is when the victim cannot blow out a match held at arms length. The venom does not kill - the inability to breathe is what causes death.
• Be prepared to keep the airways open and make sure the patient does not drown on his own saliva.
• Keep the patient as immobile as possible and transport to a hospital.
• Keep in mind that shock is probably present in all snakebite cases, whether from venomous or non-venomous species. Shock can kill even more rapidly than snake venom. Acquaint yourself with the symptoms of shock. Be prepared to deal with shock symptoms in ANY snakebite victim. Even those bitten by non-venomous species. People have died of such bites in the past.

 

MEET THE VENOMOUS SNAKES OF THE PENINSULA

Naja Nivea - Cape Cobra, Geelkapel, Koperkapel.

They are said to be more aggressive during the mating season - which is usually from September to October. A bite from a Cape Cobra constitutes a grave medical emergency. Its venom is as potent as a Black Mamba's - but it injects less of it. Transport the patient as rapidly as possible to a medical facility after pressure bandaging. Be prepared to support breathing.

 

Bitis Arietans - Puff adder, Pofadder

The venom is potently cytotoxic and a bite from it is a fairly serious medical emergency. It may take hours before symptoms start to develop. Pressure bandage and transport patient to the nearest large medical facility.

 

Dispholidus Typus – Boomslang

The venom is dangerously haemotoxic and destroys the coagulant properties of the blood.