#snake-bites

To most people, snakes seem to be synonymous with fear. Fascinating though they are, they appear to be one of the most misunderstood carnivorous reptiles. We owe this, in part to the movies and in part, to religion and mythology. The myths surrounding snakes are tremendous, and this is not just in rural areas. We’re going to try and equip you with some facts, so you can better understand these reptiles and deal with snake bites in a more informed manner. 

In India deaths due to snake-bites (referring to venomous snake-bites) are estimated at well over 46,000 every year. Even though actual envenomation* takes place less often, it is best to stay prepared for an emergency. This is not only for people residing in remote rural areas (who constitute majority of the victims) but also for urban city residents. There has been a transformation of habitat for snakes from forest systems and farmlands, to villages, towns and cities. Owing to their extraordinary adaptive nature, they have managed to survive everywhere. Even though there are only a few common species that are found in and around human habitation, the Big Four are unfortunately a part of these.

The Big Four (species) make up the medicinally important snakes of India, are lethally venomous and occur commonly throughout most of India. There are of course, other species that demand utmost respect like other cobras Naja spp.*, kraits Bungarus spp., coral snakes Calliophis spp. and Sinomicrurus sp., King Cobra Ophiophagus hannah, sea snakes (Hydrophiidae) and some pit vipers (Viperidae). Bites from these are however, smaller numbers mostly because of their distribution and biological pattern.

Most of the snake-bites take place unknowingly, when the snake is accidentally threatened. In these unforeseen instances a simple strategy and presence of mind can prove to be a limb-saver and in some cases, a life-saver.

We do advise that you go through the contents of this kit in advance to be able to prepare yourself in the eventuality of a snake-bite.

  Let’s start with the don’ts. DO NOT do the following in case of a snake-bite: 

Do not suck out venom 

Do not make incision to bleed out the venom 

Do not go to traditional healers 

Do not try out home remedies 

Do not apply tourniquets 

Do not apply ice 

Do not clean out the bitten part 

Do not try to catch/kill the snake

All of the above activities either do not work or are extremely dangerous to perform. In fact, they will do more harm than good.

  The following is what you CAN and SHOULD DO:

Make sure the victim and others are at a safe distance away from the snake; do not attempt to capture the snake, get the victim and others away from it. 

Try to memorize the snake’s appearance from a safe distance. 

Remove watches / rings / other jewellery from the bitten part- these can constrict blood flow, if rapid swelling occurs.

Keep the victim calm and reassured and try not to panic. As trivial as it may sound, it will improve the victim’s ability to deal with the situation and your ability to make decisions. Try to immobilize the bitten limb; do not make the victim run and avoid making him/her walk if possible.

In case of neurotoxic bites (All elapids and hydrophiids: Cobras, King cobras, kraits, coral snakes and sea snakes), pressure immobilization (Sutherland method) with long crepe or other stretchy bandage (5 - 10 cm wide, several rolls) and splint should be applied immediately to the bitten limb; starting at the toes/fingers and working up to the groin or arm pit. DO NOT use this method in case of bites incurred from Russel’s Viper or Saw-scaled Viper.

Do not waste any time and arrange for quick transport (as safely and comfortably as possible) to the nearest hospital treating snake-bite cases. 

If possible, do try and note the time of bite and progression of symptoms.

Describe the snake and the whole incident to the attending doctor.

Anti Snake Venom Serum is the only cure.

If your neighbourhood has a high density of snakes, it is advisable to prepare a snake- bite protocol (plan of action in case of an emergency) best suited to you. Here’s what we recommend it includes:

Numbers of people to be informed first 

Name and address of nearest hospital treating snake-bites best. 

Mode of transport and related details. 

Name/contact no. of doctor, etc. Make sure all family members understand their role in an emergency.

A few rolls of crepe bandage, a splint.

A copy of the Snake-bit First Aid Management Kit.

  SNAKE-BITE FIRST AID: PRESSURE IMMOBILIZATION METHOD FOR BITES ON THE LEG

Note: Do not attempt to remove pants as the movement will assist the venom to travel and enter the blood stream. If the pants are too tight to be rolled up, apply bandage over the pants. Keep the person as calm as possible.

1. Apply a broad pressure (crepe) bandage. Start from the toes and work your way up covering the bite, as soon as possible. Keep the bitten leg still at all times. 

2. The broad pressure bandage should be as tight as applied to a sprained ankle.  

3. Extend the bandage as high as possible. 

4. Put a splint along the length of the leg (on the outer side) and bind it to the leg using another roll of bandage. This will immobilse the joint on either side of the bite. 

5. Bind it firmly to as much of the leg as possible. Again, we emphasise that walking or any movement should be restricted and kept to a bare minimum at all times.

  SNAKE-BITE FIRST AID: PRESSURE IMMOBILIZATION METHOD FOR BITES ON THE HAND/ARM

Note: If you do not possess a broad pressure (crepe) bandage, it is best to do nothing at all. Crepe bandage is used only because of its stretchable property. Normal cloth will not work.

1. Apply a broad pressure (crepe) bandage. Start from the fingers, work your way to the elbow covering the bite, as soon as possible. Keep the bitten arm very still. 

2. The broad pressure bandage should be as tight as applied to a sprained ankle. 

3. Apply a separate bandage from elbow upwards and extend as high as possible. 

4. Put a splint along the length of the arm(on the outer side). Bind it to the arm using another roll of bandage.

5. This will immobilse the joint on either side of the bite. Put the arm in a sling. Again, we emphasise that any movement should be restricted to a bare minimum. 

Terms explained: 

*There are bites in which there is no venom injected; these are called dry bites. However, it is imperative that this is diagnosed by a doctor/ someone experienced.

*ssp. is abbreviated for species (plural form) when something is applied to many species within the same genus, but not all species within the genus.

The above given content can be downloaded in print friendly version too. Here are the links -

Sheet 01

Sheet 02

Sheet 03 

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Bibliography:

Content by Soham Mukherjee in consultation with Dr. David A Warrell and Rom Whitaker.

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