If a snake bites...

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Created on Monday, 21 January 2013 12:07

Omeshnie Naidoo -

A green mamba snake (photo) bite can be fatal.

Snakebites are more common in the summer months, particularly in the warm and wet weather we’ve been experiencing.

Heather Skinner at Netcare St Augustine’s Hospital trauma unit, said a six-year-old boy was admitted to hospital on Christmas Day after he was bitten by a snake and nearly died.

The out-of-towners declined to comment but the boy, who made a miraculous recovery, is headed back to school this week.

At the weekend a Zululand man survived an attack by a black mamba. He was treated at Hlabisa Hospital.

“Mamba toxin works quickly,” said Dr Kevin McEwen, at the St Augustine’s trauma unit.

“It can take anything from 20 minutes to an hour-and-a-half to work in the human body, and prove fatal.”

McEwen who has seen all manner of snakebites over the years (often with the snake brought to the hospital to help verify the species and ensure the correct antidote is administered) says it’s important for people to know how to react in the event of an attack.

“It’s important to note that not all snakes are venomous. The majority of snakes are, in fact, non-venomous. However, a bite from a snake is an injury in itself that can cause a great deal of pain, therefore regardless of whether you think the snake is venomous or not, the first step is to get to a hospital immediately.”

Unlike the mamba bite, which can be fatal, nothing may happen to you early on after a bite from a boomslang. However, when you awaken in the morning you might find that your gums bleed when you brush your teeth or a little scratch may cause bleeding. This is because the venom begins to work only after 24 hours in the human body.”

Once you get to a hospital a non-venomous bite is treated as an injury while a venomous bite must be treated with anti-venom. According to McEwen there are three venomous groups.

* Cytotoxic venom affects tissue and blood vessels. Snakes such as puff adders carry this venom. It causes extreme pain, swelling of limbs and blistering. An untreated bite may cause death due to loss of blood, dehydration and secondary infection.

* Neurotoxic venom affects the nervous system. Mambas and cobras carry this venom. Symptoms include pins and needles, dizziness, poor co-ordination, slurred speech, excessive salivation and drooping eyelids. This is followed by difficulty in breathing.

* Haemotoxic venom affects the blood cells. Snakes in this group include the boomslang. Early symptoms include headaches, nausea, diarrhoea, lethargy, mental disorientation, bruising and bleeding at the site and all body openings.

A number of factors determine the severity of a bite, including the victim’s health, where he or she has been bitten, the snake species, how much venom was released and how long it takes for that person to get treatment. Venom spreads via the lymphatic system. An aggressive bite can also trigger an anaphylactic reaction, which is potentially fatal.

The mortality rate from snakebite is around one in every 68 bites, resulting in about 15 fatalities a year in South Africa. McEwen says the occurrence is unpredictable by nature, however it is anticipated at this time of year.

He suggests calling ahead en route to hospital and describing the snake – this, with the patient’s symptoms, will help the doctor determine what treatment is required.

Anti-venom is kept refrigerated and is injected into the bloodstream, not the muscle, and not into the bite site, and given in sufficiently large quantities to be effective.

Don’t do what you see |on TV either, such as cutting |or sucking on the wound.|Don’t put anything into the wound, such as potassium permanganate, and don’t |give the patient anything to|eat or drink.

The Zululand man who was bitten by a mamba, Makhundu Thusi, ingested potassium permanganate – not advisable, says McEwen. For neurotoxic and haemotoxic snakebites, it may help to wrap a crepe or pressure bandage firmly around the area of the bite, covering the entire limb.

Apply hand pressure at the site of the bite until a bandage or strips of fabric can be obtained. Keep the person as still as possible and immobilise the affected limb by binding splints (with straight branches, for example) to either side of the limb. If a snake spits into someone’s eyes, rinse with plenty of water, preferably by holding the head under a running tap.

This will also require treatment at hospital: anti-venom dropped on to the eye may be needed. Observe the person closely and record any symptoms and the time taken for them to appear. If the patient stops breathing, begin CPR or advanced life support.

McEwen’s advice is practical – steer clear of all snakes. One of the most common snake attacks is said to be from the stiletto snake (an adder), which looks like a harmless earth-worm, so better safe than sorry.

Avoid keeping the exotic kind as pets as often their anti-venom is not locally available. When picnicking or hiking wear the correct gear, such as boots, and stay on designated paths. When in the wild put your hands where you can see them. And lastly, beware of “dead” snakes – they are not to be under-estimated.