Snakebite Response Guide: What to Do in an Emergency

Snakebites can be a serious medical emergency, especially when the snake involved is venomous. In countries like Australia and South Africa, where dangerous species are present, knowing how to respond quickly and effectively is essential. This guide will help you understand what to do in the event of a snakebite and how to potentially save a life.

Step 1: Scene Safety First
Before assisting anyone with a snakebite, it’s essential to ensure the scene is safe. Take precautions to avoid a second bite to yourself or others. Keep a safe distance from the snake if it’s still nearby.

Step 2: Assess the Victim : C-A-B Approach
Focus on Circulation, Airway, and Breathing (C-A-B). Provide necessary life-saving interventions if there are any issues with breathing or circulation.
C – Circulation: Check for signs of circulation. If necessary, begin CPR or apply pressure to stop bleeding.
A – Airway: Ensure the victim can breathe freely.
B – Breathing: If the victim is not breathing, commence resuscitation and seek immediate medical help.

Treatment by Venom Syndrome

Cytotoxic Bites (Tissue-Damaging Venom)

Commonly seen with species like the Eastern Brown Snake (Australia) or the Puff Adder (South Africa), cytotoxic venom causes intense pain, swelling, and tissue damage. Cytotoxic venom can cause significant tissue damage, swelling, and pain at the bite site. Here’s how to handle it:

Remove Constricting Items: Rings, bracelets, watches, or tight clothing near the bite should be removed immediately to prevent complications from swelling.

Mark the Swelling: Use a pen to circle the bite area if visible and record the time of the bite on the skin. As swelling progresses, continue marking the area and document its spread.
Elevation: Keep the affected limb or area elevated to reduce swelling.

Seek Rapid Medical Care: Transport the victim to the nearest hospital as quickly as possible.

Neurotoxic venom can impact the nervous system, leading to muscle paralysis and difficulty breathing. Drooping eyelids, slurred speech, difficulty breathing or bleeding from the gums are all symptoms that can occur.
Neurotoxic venom can also cause paralysis and other severe symptoms.
Dangerous neurotoxic species include the Black Mamba and Cape Cobra (South Africa), as well as the Taipan and Tiger Snake (Australia).

Swelling due to cytotoxic venom starting at the bite site and progressing up the limb.
Immense pain with the affected area being warm and hard.
Complications include blistering, bleeding under the skin, necrosis, pseudo compartment syndrome, nerve and vessel entrapment, deep vein thrombosis, hypotension, and hypovolaemic shock.
Species responsible: Puff Adder, Gaboon Adder, some of the dwarf Adder species, Spitting Cobras (Mozambique Spitting Cobra & Black Spitting Cobra), Stilleto Snakes, and Night Adders.

Neurotoxic Bites (Nervous System-Affecting Venom)

Progressive weakness and paralysis is due to neurotoxic venom. This syndrome can lead to complete paralysis, respiratory failure and cardiac arrest.
Complications include: muscle spasms, drooling, incontinence, salivation, lacrimation, diaphoresis, dilated pupils, dyspnoea, respiratory failure and death.
Species responsible: Black Mamba, Green Mamba, Non-spitting Cobras (Cape Cobra, Snouted Cobra & Forest Cobra), Berg Adder and the Desert Mountain Adder.

Neurotoxic Snakebites: Special Considerations
Pressure Immobilization Technique (PIT): This is critical, apply a broad, firm bandage over the bite site, then wrap the entire limb, starting from fingers/toes up towards the torso.
Splint the Limb: Immobilise the joint above or below the bite.
Stay Still: Movement accelerates the venom spread. Bring transport to the victim.

Haemotoxic Bites (Hemotoxic)

History may include need for the snake to be “pulled off” the bite site (back-fanged). The snake holds or bites into your leg, with its fangs digged into your body. Bleeding tendencies are caused by haemotoxic venom.
This syndrome eventually leads to widespread internal bleeding. Bite site bleeding early on
Later complications include: Haematuria, haemoptysis, melena, epistaxis, cerebral haemorrhage, hypotension, and hypovolaemic shock. (12-36 hours).
Species responsible: Boomslang and Vine Snakes (South Africa)

First Aid for Neurotoxic Snake bites

Apply a Pressure Bandage: This is crucial for neurotoxic bites to slow venom spread but ensure adequate circulation at the end of the limb. Check frequently for circulation and loosen if necessary.
Apply a Pressure Bandage: In the case of neurotoxic bites, such as those from the Black Mamba or Taipan, a pressure bandage can slow the venom’s spread. Ensure the bandage is snug but not cutting off circulation. Always check that circulation remains intact at the farthest point of the limb (e.g., fingers or toes).
Tourniquets (Use Only When Absolutely Necessary): A tourniquet may be used if a pressure bandage is unavailable, and you’re more than 90 minutes from medical help. For a confirmed Black Mamba or Cape Cobra bite, apply the tourniquet above the bite site and replace it with a commercial tourniquet if one is available. DO NOT remove the tourniquet unless severe swelling occurs.
Seek Immediate Medical Help: Neurotoxic venom acts quickly, and time is critical. Get the victim to a hospital as soon as possible.

Final Thoughts

Snakebites can be frightening, but staying calm and following these steps can significantly improve the outcome. Always prioritize getting to a medical facility for professional care and treatment.

General Snakebite First Aid Tips:
Stay Calm: Keeping the victim calm is key. Anxiety can speed up the spread of venom.
Minimize Movement: Have the victim lie down and stay still to slow the circulation of venom.
Monitor for Changes: Keep an eye out for symptoms such as difficulty breathing, excessive swelling, or loss of muscle control.

Key Examples of Venomous Snakes in Australia and South Africa

In Australia:
Eastern Brown Snake: One of the deadliest snakes in the world, it is responsible for most snakebite fatalities in Australia. Its venom can cause paralysis and death if untreated.
Taipan: Known for its fast-acting venom, the inland Taipan’s bite is highly neurotoxic and requires immediate treatment.
Tiger Snake: Found in coastal areas, its venom contains both neurotoxic and coagulant properties, affecting the nervous system and blood clotting.

In South Africa:
Black Mamba: Possibly the most feared snake in the world, the Black Mamba’s venom is highly neurotoxic and can kill within hours if untreated.
Puff Adder: Known for its slow strike, the Puff Adder’s venom is cytotoxic, causing severe swelling and tissue damage.
Cape Cobra: Another neurotoxic species, its venom causes paralysis and respiratory failure, which can be fatal without prompt treatment.