Treatment of Snake Bites

HOW ARE SNAKE BITES TREATED?
• Wash the bite with soap and water.
• Restrict movement. Immobilize the bitten area and keep it lower than the heart.
• Remove any rings or constricting items because the affected area may swell. Create a loose splint to help restrict movement of the area
• Cover the area with a clean, cool compress or a moist dressing to minimize swelling and discomfort
• Monitor vital signs. temperature, pulse, rate of breathing, and blood pressure
• Apply a bandage, wrapped two to four inches above the bite, to help slow the venom. This should not cut off the flow of blood from a vein or artery - the band should be loose enough to slip a finger under it.
• A suction device can be placed over the bite to help draw venom out of the wound without making cuts. These devices are often included in commercial snake bite kits.
• DO NOT apply a tourniquet as it can block arterial blood flow to the affected area and worsen tissue damage
• DO NOT apply cold compresses to a snake bite.
• DO NOT try to suck out the venom by mouth.
• Do not slash the wound with a knife.
• Do not apply ice or immerse the wound in water.
• Do not drink alcohol as a pain killer.
• Do not drink caffeinated beverages.
• Bring in the dead snake only if this can be done safely. Do not waste time hunting for the snake, and do not risk another bite if it is not easy to kill the snake. Be careful of the head when transporting it -- a snake can actually bite for up to an hour after it's dead (from a reflex)

FIRST AID TREATMENT.
• General principles:
o Appropriate first aid has been shown to reduce mortality in patients who have been bitten by a venomous snake. Some traditionally recommended procedures may do more harm than good. For example incising the wound, sucking the wound, applying a tourniquet, ice or chemicals should be avoided.
o Follow basic emergency life support principles.
o Reassure the patient.
o Keep the patient still and immobilised.
o Arrange immediate transfer for definitive care.
• Non-venomous snake bites:
o The majority of snake bites in the UK will be non-venomous such as those from pythons and constrictors.
o These snake bites should be treated in the same way as any other animal bite.
o Clean and dress the wound
o Give anti-tetanus prophylaxis as required
o If the precise identity of the snake is unknown, keep under observation for several hours
If there are any systemic features (such as limb oedema, hypotension), assume that the bite is venomous and call the local poisons centre for further advice.
o Local blistering and transient dizziness and nausea are not suggestive of systemic involvement.
• Venomous snake bites:
o Venomous snake bites are very rare in the UK and are most commonly the result of an adder bite.
o Venomous snakes, even when they bite, do not always inject venom or not enough venom to cause envenomation.
o If the venom causes local damage and not neurotoxicity, like the adder bite, then pressure-immobilisation is not recommended. However an affected limb should be immobilised.
o In Australia most of the venomous snakes are systemically neurotoxic.16 Where a venomous snake other than an Adder is thought to have been involved (or snake not identified) the first aim is to prevent the snake venom from being systemically absorbed. In such cases a pressure immobilisation (PIM) bandage including a splint to reduce movement should be applied to the affected limb as soon as possible following the bite. The wound should not be cleaned prior to the application of the bandage, as traces of venom around the bite may help to identify appropriate anti venom if this is required.17 The following method is suggested for application of a PIM bandage:
 Identify the site of the bite from the patient's account (there may be no visible evidence of a bite mark).
 From the site of the bite, apply a compression bandage from the digits to the proximal end of the limb.
 The bandage should not be constricting (tension approximates to that applied for a sprained ankle).
 Mark the site of the bite on the outside of the bandage to allow a small window to be cut in the bandage for venom swabs to be taken.
 Apply a splint to immobilise the limb, and transport the patient to the nearest Accident and Emergency department. Keep movement to a minimum.
 For bites to the head neck and torso, local pressure should be applied