Snake bite

From Ganfyd

A large number of snake species are an envenomation risk to man. Only a few islands such as New Zealand have no terrestrial poisonous snakes and even there sea dwelling coral snakes are a potential danger in warmer latitudes. Antivenom is available for many but there is always the issue of identifying correctly the snake. South East Asia guidelines on the management of snake bites are a good general reference source^[1] as national guidelines will tend to concentrate on endemic species which is not much use if a zoo keeper gets bitten or the snake has survived air travel and bites a cargo handler. World wide it has been estimated that 5 million people are bitten by venomous snakes annually and more than 100,000 die^[2]. Viper venom tends to be haemotoxic and necrotoxic, while Elapidae such as cobra's and carol snakes tend to have neurotoxic predominant venom.

First-aid (many traditional methods cause more harm than good e.g.: mouth suction, wound incision, and application of ice or heat): Reassurance Immobilisation of whole patient and particularly the bitten limb (below heart level) Transfer patient to treatment centre as soon as possible

Vipera berus"" the Common European adder. See Adder bites: NHS Choice

• Polyvalent antiserum against Viperidae family only recommended if life threatening bite as antivenom has high incidence of serious hypersensitivity reactions

See Medscape on snake bite for ID. Reviews exist^[3]. Pit vipers such as rattlesnakes treated with either:

• Antivenin Crotalidae Polyvalent (ACP)
• Crotalidae Polyvalent Immune Fab (CroFab) - less immunogenic

See Australian Snake Bites for ID and upto date information. The wide range of highly toxic species means identification can be rather important to choose the right antitoxin and good reviews exist^[4].

References