South-east Queensland is home to approximately 27 snake species, but only 13 are regarded as medically significant. If you are unlucky enough to be bitten, here is a guide of what and what not to do in the event of a snake bite.
NOTE: All snake bites should be treated as venomous especially in the absence of reliable identification and first aid action should be applied immediately with Pressure Immobilisation Bandaging and call 000.
In the majority of scenarios bites from venomous snake species are somewhat pain free, even to the point in some cases that unsuspecting people have been unaware of the bite. The bite itself may appear somewhat innocuous more often resembling lacerations or scratches than the two puncture marks synonymous with most peoples expectation of a snake bite.
Occasional bruising may occur however bleeding is generally minimal. A lymphatic response is common and may be quite severe in some cases. Initial symptoms may include headache, nausea, vomiting, diarrhoea, irritability, light sensitivity, disorientation; inconsistent coagulation and potentially a loss of consciousness. Secondary symptoms may include difficulty swallowing, double vision, drooping of the eyelids, blood in the urine, abdominal pain, rapid increase in heart rate. Severe symptoms which may in extreme cases lead to death include marked loss of color or discoloration resulting in circulatory failure, loss of limb function due to paralysis and respiratory muscular apathy leading to respiratory failure.
The consistency of these events is unpredictable and a number of factors must be considered when assessing an individual's response to envenomation. These factors may include:
The time frame, in which symptoms become evident and escalate, again is highly variable and not easily quantified. Where a number of the factors presented above are adverse symptomatic onset may be rapid in the case of bites from highly toxic species. Anaphylaxis is also a common cause of symptomatic response where although the toxicity of a snake may not be considered of high risk an individual's physiological response may promote an escalated allergic reaction to compounds particular to that venom type.
Lymphatic progression: the vital ingredient.
Before illustrating correct first aid it's of great benefit to understand the mechanism by which venom actually progresses from the bite site and throughout the body. In the vast majority of cases venom moves initially through the secondary circulatory system, otherwise known as the lymphatic system. Where a bite is received directly to a vein or artery progression may be afforded by this means however this event is rare.
The intention of first aid application is to greatly inhibit the progression of venom through the body. To do this, the key ingredients when considering the reduction of lymphatic movement are compression and immobilisation. Pressure applied by a bandage reduces opportunity for lymphatic function and in turn immobilisation disengages voluntary and involuntary muscular movement. The application of correct first aid that implements this strategy has proven to be highly effective and undoubtedly not only saved many lives but has reduced the onset of symptomatic responses prior to receiving increased levels of intervention such as antivenin administration.
The implementation of current first aid is critical immediately after receipt of a bite from a snake. The "pressure-immobilisation" technique is currently recommended by all major health organisations within Australia. A number of "do nots" are applicable to snake bite management. These are as follows:
Do not try to catch or kill the snake. Statistically 95% of people that are admitted to hospitals for snakebite treatment have attempted to catch, kill or otherwise engage with the snake.
Do not wash the bite site. In many cases the application of a Venom Detection Kit (VDK) may be applied to assist in identifying the snake responsible. Residual venom from the bite site is in this instance the most accurate means of identifying a snake where a specimen is not provided. This in turn means that the specific antivenin is administered rather than a polyvalent which carries higher risk of anaphylactic response.
Do not give food or drink - In the event of significant delay or where dehydration is an issue small sips of water are acceptable. Alcohol especially should be avoided.
Do not lance or suck the bite. Sucking the venom out may cause a secondary envenomation and is likely not to remove all the venom anyway.
Do not apply a tourniquet. This method is ineffective and can result in severe injuries to the patient due to loss of circulation to the effected limb. When released the rapid progression of venom may cause an onset of symptomatic response that is highly accelerated.
Do not unnecessarily move the person bitten. Application of first aid should be done as soon as the bite is received or when first noticed. Again unnecessary movement results in lymphatic activity which is what is to be avoided at all costs.
Do not remove the bandages or splints at any stage after they are applied. Only when additional medical support under direction of a treating doctor should bandages be removed. Only when appropriate antivenom and resuscitation equipment is on hand should any first aid be removed.
Correct First Aid For Snake Bite:
Snake bites can occur anywhere on the body. Correct first aid for each of the following body divisions is provided. These include:
The procedure for correct first aid should be implemented as follows:
Bites to a limb:
Bites to a Torso:
The compression technique in this instance is varied due to the structure of the torso as opposed to an elongate limb.
Bites to a Head or Neck:
For further information regarding snake bite management visit paradisefirstaid.com.au