WHAT TO DO IF BITTEN BY A SNAKE

It was a day like every other day in medical school-tiring and absolutely draining. It was 4th year, and a pathology lecture was ongoing, when a snake decided to join the class.

My class in medical school was a small one, of just about 48 students. We were all listening, or at least trying to listen with rapt attention to our pathology lecturer when someone sitting near the front door to the left of the lecture hall screamed “snake!”

Almost within a split second, I found myself standing on a desk along with several others on their respective desks, while some others had already fled the hall using the back door. Even our pathology professor had made his way out through the nearest door. Eventually, a few brave members of the class located and killed the invading reptile. The less brave ones like myself only got a look at the slithering reptile when we were sure it had been killed, I mean, “very killed”. I was not going to take any chances at all, I dreaded and still dread those creatures and I did not come to medical school to take chances with snakes.

Everyone probably has seen a snake, many have almost been bitten by one and a few have actually been bitten by one during their lifetime. Snake bites are dreaded because you can never know what may be the outcomes and myths about snake bites abound.

WHAT IS SNAKE BITE?

Snake bite is an injury caused by a bite from a snake. A snake bite can be life threatening if the snake is venomous.

TYPES OF SNAKES/SNAKE BITES

There are about 2500-3000 species of snakes distributed worldwide. Out of these species, about 500 are venomous. There are 4 venomous snake families in Africa:

1. Vipers and adders
2. Cobras and mambas
3. Boom slang
4. Sea snakes.

There are 2 different types of snake bites, and one is more serious than the other. They are:

1. Dry bites or non-venomous snake bites: 

This is when a snake does not release any venom with its bite. This is mostly seen in non-venomous snakes.

2. Venomous bites:

These are more dangerous and occur when a snake releases venom with its bite. Poisonous snakes voluntarily release venom and they can control the amount of venom they release during a bite.

Still, every snake bite should be treated as a medical emergency as any delay of treatment following a venomous snake bite could result in serious injury or in the worst case scenario, death.

HOW COMMON ARE SNAKE BITES?

According to the WHO, about 81,000- 138,000 people die yearly because of snake bites worldwide.

In Nigeria 497 out of 100,000 people are bitten by a snake yearly, and 12% die naturally.

WHO IS LIKELY TO BE BITTEN BY A SNAKE?

Anyone can be bitten by a snake, however these particular groups of people are more likely to be bitten and suffer greater harm if bitten by a snake:

1. Poor rural dwellers, agricultural workers, herders, fishermen, hunters, working children aged 10-14 years.
2. People living in poorly constructed housing and people with limited access to education and health care.

Complications and death occur most frequently among people aged 10-30 years, and women experience a lot of barriers to accessing medical care in some cultures e.g in Northern Nigeria. Pregnant women are very likely to bleed and have a miscarriage after a venomous snake bite.

SIGNS AND SYMPTOMS OF SNAKE BITE:

If a person has been bitten by a snake, the symptoms will depend on what type of bite. If it is a non venomous or non poisonous snake bite (dry bite), there is likely to be swelling, and redness around the area of the bite. If it is a venomous snake bite, there will be more symptoms, common among which are:

1. Bite marks on the skin
2. Sharp or burning pain around the bite, which may not be felt for a little while after the bite. The pain may extend all the way up on the part of the body that was bitten, but not everyone feels pain even after a venomous bite.
3. Rednes, swelling and destruction of tissues around the bitten area.
4. Abnormal blood clotting and bleeding, which can lead to damage to organs like the kidney.
5. Low blood pressure, faster heart rate, weaker pulse.
6. Nausea and vomiting, diarrhea, headache, dizziness, blurred vision
7. Difficulty breathing or complete loss of breath
8. Increased sweating and saliva production
9. Weakness of the muscles
10. Numbness in the face or limbs
11. Difficulty in speaking due to tightness in the throat and a swollen tongue, and many more symptoms.

PREVENTION OF SNAKE BITES:

1. Avoid approaching or handling snakes in the wild
2. Avoid places with tall grass, piled leaves, rocks, and wood piles where snakes are likely to be present 
3. If you encounter a snake, give it space to retreat and let it take cover
4. When working outside where snakes may be present, wear tall boots, long trousers , and leather gloves 
5. Avoid working outside at night and in warm weather where snakes are most active.

WHAT TO DO IF BITTEN BY A SNAKE

If you or anyone else is bitten by a snake, it is important to get emergency treatment as soon as possible. Here are the things to do:

1. Call for help
2. Note the time of the bite
3. Keep calm and still because movement can cause the venom to travel more quickly through the body.
4. Remove constricting clothes or jewelry because the area around the bite will likely swell.

Things to not do:

1. Do not allow the victim to walk. Carry them or transport them by a vehicle.
2. Do not kill or handle the snake. Take a picture if you can, but don’t waste time hunting it down.
3. Do not tie the leg
4. Do not cut into the snake bite
5. Do not use ice on the bite
6. Do not give the person medications unless instructed by a doctor
7. Do not raise the area of the bite above the victim’s heart.
8. Do not try to suck out the venom by the mouth.

TREATMENT

The most important thing is to get medical help as soon as possible. A doctor will evaluate the victim to decide on a specific course of treatment. In some cases, a bite from a venomous snake is not life threatening. If the bite is not serious, the doctor may clean the wound and give a tetanus vaccine. If it is serious, an antivenin may be administered to counter the effect of the snake venom. 

The sooner the antivenin is used, the more effective it will be. Wound cleaning and prompt treatment give good results if done immediately after the bite.