Brief overview
- What to do in case of a snake bite? First aid: Calm the victim, immobilize him, if necessary treat the wound and remove jewelry/clothing. Take affected person to hospital or call emergency services.
- Snakebite risks: Nerve and muscle damage, blood clotting disorders, circulatory problems, allergic reactions (itching, nausea, drop in blood pressure, etc.), serum sickness (when antivenom is administered).
- When to see a doctor? Always. Every snake bite is an emergency, as the danger they pose usually cannot be assessed on the spot.
Attention:
- Some snakes play dead when in danger! Furthermore, even dead snakes and even severed snake heads can still snap reflexively! Therefore, you should not touch a (supposedly) dead snake (without protective measures) or photograph it from close up.
- Fear and movement cause snake venom to spread through the body more quickly. Therefore, be sure to keep the victim as calm and still as possible.
Snake bite: What to do?
In the case of a snake bite, first aid aims primarily to delay any poisonous effects until the patient can receive medical attention. It is also about reducing the patient’s pain and anxiety. In detail, first aid for snakebites is as follows:
- Reassurance: After a snake bite, many people are very afraid. But agitation and panic reactions accelerate the distribution of invaded snake venom in the body. Therefore, you should be reassuring to the patient.
- If necessary, treat the wound: If possible, leave the bite wound alone. At most, you should disinfect it and cover it with a sterile or at least clean bandage. However, this bandage must not be too tight and impair the blood circulation!
- Remove jewelry and clothing: In the case of a snake bite on the hand or arm, you should quickly remove rings, bracelets, watches and constricting clothing before the tissue swells. For a snakebite on the leg, remove tight-fitting shoes and tight pants (cut them open if necessary).
- Get to a doctor immediately: get the patient to the nearest hospital as soon as possible. During transport, he should move little; if necessary, transport him lying down. If possible, have the ambulance service pick up the patient.
The actions taken in many movies after a snake bite are often anything but advisable. Under certain circumstances, they may do more harm than good. You should therefore take the following to heart after a snake bite:
- Do not tie off: Tying off cuts off blood flow, pinches nerves, and increases the local venom effect. As a result, tissue can swell extremely and even die (necrosis). In addition, bleeding into the congested limb is possible.
- Do not cauterize, incise, or excise: Such measures are unlikely to reduce the amount of toxin in the body, but rather may promote the spread of the toxin (if larger vessels are destroyed). In addition, dangerous bleeding may occur (if blood clotting is disturbed).
- Do not suck out: You cannot create sufficient negative pressure with your mouth to suck out enough snake venom from a bite wound. In addition, you could poison yourself in the process.
Snake bite: risks
What a snake bite looks like, many people know at least roughly thanks to its more or less characteristic bite mark: The bite usually shows up in the form of two adjacent, punctiform puncture marks. If a venomous snake has bitten and venom has actually been injected, further symptoms will develop – usually 15 to 30 minutes, but sometimes not until several hours after the snake bite.
Snake venom
Snake venom is a watery secretion from special salivary glands of venomous snakes. When bitten, it usually enters the victim’s body via a hollow front tooth in the upper jaw (in the case of trug snakes, via poisonous teeth in the back of the throat) – although not in every snake bite. There are also so-called “dry” bites, where a venomous snake bites but does not inject venom into the skin of its victim.
Serum sickness
Patients who have received an antivenom (antiserum) after a snake bite can develop the so-called “serum sickness” after a few days. This refers to late allergic reactions such as hives, mild tissue swelling (edema), and joint pain. They can be treated with medication (with antihistamines and cortisone).
Other risks
Snakebites are usually sterile, so they do not usually introduce germs into the wound. This means no primary infections usually occur. However, germs can subsequently enter and then cause a so-called secondary infection. But this rarely happens.
A survived snake bite usually has no permanent consequences – apart from possible tissue loss (through necrosis) and possibly an amputation. The latter may be necessary, for example, if the bite wound was treated improperly.
Risk in this country: Adder bite
Adders belong to the vipers and are the most common poisonous snakes in German-speaking countries. If (sufficient) venom has been injected in a viper bite, a painful swelling quickly forms around the bite mark. This can turn bluish and spread to the entire limb and even further. In addition, the lymph nodes in the affected region of the body often swell and the lymph vessels become inflamed (lymphangitis).
In addition, many patients show sometimes violent panic reactions after a viper bite. General symptoms such as abdominal pain, nausea and vomiting are also sometimes observed.
Only in rare cases do more severe symptoms of poisoning develop. For example, a bluish blister may form at the bite site and tissue may die (necrosis). Severe circulatory problems with palpitations, drop in blood pressure and circulatory shock are also rather the exception.
Symptoms after snakebites
It depends essentially on the composition and dose of the injected venom mixture, which symptoms occur, how severe they are and how dangerous it can become for the patient. Basically, there are five symptom complexes that can occur after snakebites:
Nerve damage (neurotoxic symptoms).
The venom injected during a snake bite can block the peripheral nervous system. Paralysis of the striated muscles then occurs. Initial signs include drooping of the upper eyelids (ptosis) and paralysis of the facial and jaw muscles. As the disease progresses, the paralysis spreads to the respiratory muscles, which can lead to death by asphyxiation.
These neurotoxic snakebite symptoms are caused by cobras, mambas, sea snakes, and some rattlesnakes, for example.
Muscle damage (myotoxic symptoms).
The destruction of muscle tissue is also noticeable in that the creatine kinase level rises in the blood and myoglobin can be detected in the urine: both proteins are normally present inside the muscle cells and are released during cell destruction.
The released myoglobin stains the urine dark brown. It can also damage tubule cells in the kidneys, which can lead to kidney failure.
Such myotoxic symptoms may result, for example, from the bite of some vipers, rattlesnakes, poisonous snakes, and sea snakes.
Blood clotting disorder
Especially after a viper-snake bite, but also after the bite of trick snakes (such as African tree snakes), such a severe blood clotting disorder can develop.
Swelling (edema) around the bite site.
If the tissue area around the snake bite swells (edema), this indicates that venom was indeed injected. The edema can be massive and spread rapidly to the entire arm or leg. If the bite is from a viper or rattlesnake, extensive hemorrhaging of the skin (with blisters) will form around the bite site. In addition, surrounding tissue dies (tissue necrosis).
Circulatory problems
Occasionally, a snake bite causes shock and circulatory problems, such as nausea, weakness, and dizziness.
Snake bite: When to see a doctor?
Basically, every snake bite is a potential emergency and should be treated as such. This means always take the victim to a doctor or call emergency services.
The good news is that about 50 percent of all snakebites (including those from venomous snakes) are “dry” or “empty” bites, where no venom has been injected. They leave a bite mark, but do not cause widespread poisoning symptoms such as muscle or nerve damage. This is also true in the case of an adder bite. Even if venom has been injected in the process, it is often so little that no symptoms develop other than local swelling at the bite site. Only rarely does an adder bite cause severe poisoning and deaths are even the absolute exception.
However, since it is usually difficult to assess how dangerous the snake bite is in individual cases, it should always be examined by a doctor.
Snake bite: examinations by the doctor
- When and how did the snake bite occur?
- How much time has passed since then?
- Do you know what type of snake bit?
The doctor will then examine you immediately. He will carefully inspect the bite wound, check your vital signs (such as breathing and blood pressure), and take blood and urine samples for analysis in the laboratory. He will then initiate appropriate treatment as soon as possible.
Snake bite: treatment by the doctor
The doctor will treat the bite wound in a sterile manner and closely monitor its further progress. He will monitor pulse, blood pressure, respiration and neurological values.
In addition, he will treat the various symptoms as needed. For example, if you have severe pain, you will be given painkilling medications (analgesics). If you have circulation problems, you will probably receive fluids and electrolytes (as an IV) and possibly blood pressure-raising medications. If you have breathing problems, artificial respiration may be necessary.
Administration of an antiserum
An antidote (antiserum) is available for some snake venoms. It is administered directly into a vein in cases of severe poisoning symptoms. This should only be done by a doctor because the patient may have an allergic reaction to it. In the worst case, a severe allergic shock (anaphylactic shock) occurs, which must be treated immediately by a doctor!
An antivenom should always be administered as soon as possible after a snake bite. The more time passes, the higher the dose of the antiserum must be and the lower the chances of successful treatment (exception: if blood clotting is disturbed by the snake bite, the administration of an antiserum is always helpful).
Other measures
If you do not have vaccination protection against tetanus (lockjaw), the doctor will give you a tetanus shot to be on the safe side.
Prevent snakebite
To avoid a snake bite, heed the following advice – especially if you’re traveling in tropical subtropical areas:
- Proper clothing: When hiking in untracked terrain, wear high, sturdy shoes and long pants; in very high-risk areas, you may want to wear special gaiters.
- Vibration: Firm footing can drive snakes away, as can the use of a walking stick (they respond to vibrations).
- Eyes out: Pay close attention to where you step, sit, and reach in the field (e.g., never blindly reach into a bush).
- Do not sleep directly on the ground: If possible, never set up your sleeping place directly on the ground.
- Be careful with food scraps: Dispose of food scraps that could attract prey animals, including snakes.
