Snake Bites

Figure 1 : A snake bite
Source - www.nlm.nih.gov

Presentation

Symptoms depend on the type of snake, but may include:

• Bleeding from wound
• Blurred vision
• Burning of the skin
• Convulsions
• Diarrhea
• Dizziness
• Excessive sweating
• Fainting
• Fang marks in the skin
• Fever
• Increased thirst
• Loss of muscle coordination
• Nausea and vomiting
• Numbness and tingling
• Rapid pulse
• Tissue death
• Severe pain
• Skin discoloration
• Swelling at the site of the bite
• Weakness

Figure 2 : Symptoms of snake bite
Source - www.wildbackpacker.com

Symptoms of rattlesnake bites include:

• Bleeding
• Breathing difficulty
• Blurred vision
• Eyelid drooping
• Low blood pressure
• Nausea and vomiting
• Numbness
• Pain at site of bite
• Paralysis
• Rapid pulse
• Skin color changes
• Swelling
• Tingling
• Tissue damage
• Thirst
• Tiredness
• Weakness
• Weak pulse

Symptoms of cottonmouth and copperhead bites include:

• Bleeding
• Breathing difficulty
• Low blood pressure
• Nausea and vomiting
• Numbness and tingling
• Pain at site of bite
• Shock
• Skin color changes
• Swelling
• Thirst
• Tiredness
• Tissue damage
• Weakness
• Weak pulse

Coral snake bites may be painless at first. Major symptoms may not develop for hours. Untreated coral snake bites can be deadly. Symptoms may include:

• Blurred vision
• Dyspnea
• Convulsions
• Drowsiness
• Eyelid drooping
• Headache
• Hypotension
• Excessive salivation
• Nausea and vomiting
• Numbness
• Pain and swelling at site of bite
• Paralysis
• Shock
• Slurred speech
• Swallowing difficulty
• Swelling of tongue and throat
• Weakness
• Skin color changes
• Skin tissue damage
• Stomach or abdominal pain
• Weak pulse

(Heller J. L. 2014)

Causes

Figure 3 : A snake
Source - doowansnewsandevents.wordpress.com

Venomous snake bites include bites by any of the following:

• Cobra
• Copperhead
• Coral snake
• Cottonmouth (water moccasin)
• Rattlesnake
• Various snakes found at zoos

(Heller J. L. 2014)

Investigations

Assessment of snake bites are usually done as clinical assessment.

Rapid clinical assessment 

Maintain and clear the airway, ventilate with Ambu bag and mask or ET, Establish IV access, infuse normal saline and check BP.

Examination of bitten part 

Extent of swelling, tenderness, local lymph node enlargement, blistering

General examination 

Pulse rate and BP, skin and mucus membrane for signs of internal bleeding, abdominal tenderness, loin pain and tenderness.

Examine for neurotoxic envenoming

Early external ophthalmoplegia, motor cranial nerves examination and broken neck signs.

Investigations and laboratory tests (20WBCT and other blood tests) 

To look for evidence of bleeding, problems in the blood clotting system, kidney problems, or muscle death.

Identify the snake

(Heller J. L. 2014)

Stepwise Management

First Aid

-       Keep the person calm. Reassure them that bites can be effectively treated in an               emergency room.

-       Restrict movement, and keep the affected area below heart level to reduce the flow         of venom.

-       Remove any rings or constricting items.

-       If the snake was venomous the area of the bite begins to swell and change color.

-       Monitor the person's vital signs (temperature, pulse, respiration, and blood pressure)

-       If there are signs of shock, lay the person flat, raise the feet about a foot, and cover         the person with a blanket.

Do not,

-       Allow the person to become over-exerted.

-       Apply a tourniquet.

-       Apply cold compresses to a snake bite.

-       Cut into a snake bite with a knife or razor.

-       Try to suck out the venom by mouth.

-       Give the person stimulants or pain medications unless a doctor tells you to do so.

-       Give the person anything by mouth.

-       Raise the site of the bite above the level of the person's heart.

(Heller J. L. 2014)

• Check for evidence of fang marks or local trauma in the area of the bite.
• Different kinds of antivenom exist for different species of snakes that are venomous.

(Balentine J. R. 2014)

REFERENCES

Heller J. L. 2014. Medline Plus. [ONLINE] Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000031.htm [Accessed 27^th April 15].

Balentine J. R. 2014. Emedicine Health. [ONLINE] Available at: http://www.emedicinehealth.com/snakebite/page5_em.htm [Accessed 27^th April 15].