Written by Dr. Shyam Sundar Gupta, PhD, Medically Reviewed by Dr. Ajay Kumar Tiwari, MD (Ay.)
Snakebite is very dangerous among farmers, gardeners, laborers and other persons working in the fields, garden, and open regions and may create incidence and death. Snakes have developed the venom apparatus to get food. In India, more than 200 snake species have been known, out, of which 52 are poisonous. Indian cobra (Naja naja), Krait (Bungarus caeruleus), Russell’s viper (Daboia russelii), and saw-scaled viper (Echis carinatus) are the most venomous. When poisonous snakes bite, their venom (poison) comes into the snake’s fangs (teeth) from the venom gland through a duct, and at last into its prey.
One should follow these steps just after snake biting until medical assistance.
- Instantly victim should be moved beyond the place where the bite happened. If the snake is attached, remove it with the help of a stick or tool. If the snake biting is occurred by a sea snake (having a small head and flat tail) near to seacoast, then the victim should be shifted to a dry place to keep away from drowning.
- Try to identify the snake. Recollect the color, shape, and size, which will help with treatment.
- Remove all tight clothes or shoes or socks or jewelry or other things from the bitten area.
- Have patience and reassure the victim. Biting may be caused by a non-poisonous snake. Some poisonous snake biting doesn’t cause death immediately.
- The victim should be stable and their limbs also should be kept still to keep the venom from spreading. The stretcher should be used to carry the victim to the place where the transport facility is available to take him to the hospital immediately.
- The pressure at the biting site may be safe in some cases.
- The biting affected area should be cleaned and covered with a clean and dry dressing. Don’t clean it with water.
- Traditional first aid, herbal treatment, and other unsafe first aid must be avoided.
- Paracetamol may be used for severe pain.
- The victim should be placed on his left side during vomiting.
- Victim nearby place should be airy. His breathing should be checked. If breathing is not proper then artificial respiration should be given.
Many persons face to death due to being transported lying flat on their backside and breathing, obstructed by vomiting, or paralysis of muscles in the tongue. Carry them on their left side with mouth turned down to reduce the risk. Snake biting treatment will depend on the type of biting snake. If the snake was poisonous the victim will be given ant-snake venom. A tetanus injection also may be given.
- Use traditional remedies
- Cut, suck, uses electric shocks or wash the wound due to causing infection
- Apply ice or use compression bandage or water on the wound
- Give caffeine or caffeinated drinks (tea or coffee) alcohol due to increasing the absorption of venom in the body
- Runaway to catch the snake
The identification of poisonous snakes (3)
The snakebite treatment depends upon the type of snake, and therefore identification of snake is essential to save a life. The three main families of poisonous snakes are the Viperidae, the Elapidae, and the Hydrophidae.
Viperidae (vipers): The head is triangular and wider than the neck, and have laureal shields. They are ovi-viviparous having vertically elliptical pupils and their fangs are long, movable, and canalized similar to hypodermic needles.
Elapidae (cobra, king cobra, krait, and coral snake): The head and neck have the same width. The head lack laureal shields and is covered with large scales. They are oviparous with round pupils and their fangs are short, fixed, and covered with mucous membrane. Therefore, they cannot bite through clothes.
Hydrophidae (sea snake): They are found in the area of the seacoast. The head is small and the tail is flat that helps them in swimming. They seldom bite.
The toxic component of snake venom
Phospholipase A: It inhibits electron transfer at the point of cytochrome c and provides mitochondrial-bound enzymes soluble. It hydrolyzes phospholipids in nerve axons, breaks down acetylcholine vesicles at the myoneural junction, cause myonecrosis, and damage of red cell membranes (4).
Polypeptides: It is quickly absorbed and cause toxicity on presynaptic and postsynaptic membranes and other body organs (4).
Hyaluronidase: It helps in spreading of venom through tissues (5).
α- Neurotoxins: It binds to acetylcholine receptors at the motor end-plate (5).
β- Neurotoxins: At first it induces the release of acetylcholine at the nerve endings at the myoneural junction and then prevents further release of a transmitter (5). All this causes paralysis of the victim.
Viperidae (vipers) bites
Viperidae bites cause rapid swelling at the bitten site. Local necrosis mainly causes the insufficient supply of blood, the formation of a blood clot and dry gangrene. Hemostatic abnormalities (blood flow stopping) are symptoms of viper bites. Renal failure is frequent before death.
Elapidae (cobra, king cobra, krait, and coral snake) bites
Bites by elapidae show minimal local changes. Indian cobra (Naja naja) bites have gentle local swelling, blistering, and necrosis. Local necrosis induces an image of “wet gangrene” with a rotten smell. Abdominal pain, malaise, nausea, vomiting, and prostration are the common initial symptoms.
Hydrophidae (sea snake) bites
The sea snake biting causes muscle pains and it may last unless treated.
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