Snake Bites

from Volume 3, Number 12 of Lost ... and Found

by Joyce Rumschlag

[Disclaimer: The editors remind you that written descriptions of first aid are not a substitute for proper first aid training, and that Cibola SAR's policy is that medical decisions are properly deferred to trained medical personnel, and any member rendering first aid does so as a private citizen, not as a member of Cibola SAR!]

Prevention: Except for a few species, snakes tend to be shy or passive. Unless they are injured, trapped, or disturbed, snakes usually avoid contact with humans. The harmless species are often more prone to attack. All species of snakes are usually aggressive during their breeding season.

Avoidance: Many snakes are active during the period from twilight to daylight. Avoid walking as much as possible during this time. Since SAR members often search at night, remember to be alert for the sound of rattlesnakes and be aware that they are also active at night.

• Keep your hands off rock ledges where snakes are likely to be sunning.
• Look around carefully before sitting down, particularly if in deep grass among rocks.
• Attempt to camp on clean, level ground. Avoid camping near piles of brush, rocks or other debris.
• Sleep on camping cots or anything that will keep you off the ground. Avoid sleeping directly on the ground if at all possible.
• Check the other side of a large rock before stepping over it. When looking under any rock, pull it toward you as you turn it over so that it will shield you in case a snake is beneath it.
• Try to walk only in open areas. Avoid walking close to rock walls or similar areas where snakes may be hiding.
• Determine, when possible, what species of snakes are likely to be found in an area which you are about to enter.
• Hike with another person. Avoid hiking alone in a snake-infested area. If bitten, it is important to have at least one companion to perform lifesaving first aid measures and to kill the snake. Providing the snake to medical personnel will facilitate both identification and treatment.
• Handle freshly killed venemous snakes with a long tool or stick. Snakes can inflict fatal bites by reflex action even after death.
• Wear heavy boots and clothing for some protection from snakebite. Keep this in mind when exposed to hazardous conditions.
• Eliminate conditions under which snakes thrive: brush, piles of trash, rocks, or logs and dense undergrowth. Controlling their food (rodents, small animals) as much as possible is also good prevention.

First Aid
If a person should accidentally step on or otherwise disturb a snake, it will attempt to strike. Poisonous snakes do not always inject venom when they bite or strike a person. However, all snakes may carry tetanus (lockjaw); anyone bitten by a snake, whether poisonous or non-poisonous, should immediately seek medical attention.

Get the subject to a medical treatment facility as soon as possible and with minimum movement. Until evacuation or treatment is possible, have the subject lie quietly and not move any more than necessary. The subject should not smoke, eat, or drink any fluids. If the subject has been bitten on an extremity, do not elevate the limb; keep the extremity level with the body. Keep the subject comfortable and be reassuring. If alone when bitten, the subject should go to a medical facility alone rather than waiting to be found. Unless the snake has been positively identified, attempt to kill it and send it with the subject. Be sure that retrieving the snake does not endanger anyone or delay transporting the subject.

If the bite is on an arm or leg the pressure immobilization method can be used. Correctly applied, this technique can virtually stop venom movement into the circulation until removed, up to hours later. This method poses no threat to limb tissue oxygenation, which is just one of the major problems with tourniquets. It must be remembered, however, that this method is only first aid. It is not definitive medical treatment for envenoming. Once in a hospital equipped to treat the bite with antivenin, if necessary, then all first aid will be removed after initial precautions and testing.

In summary, the pressure immobilization method of first aid is:

• Apply a firm, broad bandage or similar (even strips of clothing or pantyhose will do in an emergency) over the bite site, at the same pressure as for a sprain. Do not occlude the circulation. The object is to compress the lymphatic vessels.
• Apply further bandage over as much of the rest of the bitten limb as practical. It is often easiest to go over the top of clothing such as jeans, rather than move the limb to remove clothing.
• Ensure the bitten limb is kept motionless by applying a splint and instructing the patient to cease all use of the limb and any general activity.

[Disclaimer: The editors remind you that written descriptions of first aid are not a substitute for proper first aid training, and that Cibola SAR's policy is that medical decisions are properly deferred to trained medical personnel, and any member rendering first aid does so as a private citizen, not as a member of Cibola SAR!]

References
CSL Antivenom Handbook
Virtual Naval Hospital
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