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Symptoms and First Aid for Venomous Snake Bites

Clinical manifestations vary between species of snakes. Some toxins in venom exert local effects such as swelling, blistering, bruising, and necrosis at the bite site. Other toxins can be distributed systemically through lymphatics and blood vessels and act at distant sites. Common systemic effects include bleeding, paralysis, generalised rhabdomyolysis, and acute kidney injury. Venom injection deep into a limb can cause tissue swelling in the tightly constrained space and compromise neurovascular function. This manifests as “acute compartment syndrome.”

Symptoms

Signs or symptoms of a snake bite may vary depending on the type of snake, but may include:

  • Puncture marks at the wound
  • Redness, swelling, bruising, bleeding, or blistering around the bite
  • Severe pain and tenderness at the site of the bite
  • Nausea, vomiting, or diarrhea
  • Labored breathing (in extreme cases, breathing may stop altogether)
  • Rapid heart rate, weak pulse, low blood pressure
  • Disturbed vision
  • Metallic, mint, or rubber taste in the mouth
  • Increased salivation and sweating
  • Numbness or tingling around face and/or limbs
  • Muscle twitching

First Aid

Workers should take these steps if a snake bites them:

  • Seek medical attention as soon as possible (dial 911 or call local Emergency Medical Services [EMS]).
    • Antivenom is the treatment for serious snake envenomation. The sooner antivenom can be started, the sooner irreversible damage from venom can be stopped.
    • Driving oneself to the hospital is not advised because people with snakebites can become dizzy or pass out.
  • Take a photograph of the snake from a safe distance if possible. Identifying the snake can help with treatment of the snakebite.
  • Keep calm.
  • Inform your supervisor.
  • Apply first aid while waiting for EMS staff to get you to the hospital.
    • Lay or sit down with the bite in a neutral position of comfort.
    • Remove rings and watches before swelling starts.
    • Wash the bite with soap and water.
    • Cover the bite with a clean, dry dressing.
    • Mark the leading edge of tenderness/swelling on the skin and write the time alongside it.

Do NOT do any of the following:

  • Do not pick up the snake or try to trap it. NEVER handle a venomous snake, not even a dead one or its decapitated head.
  • Do not wait for symptoms to appear if bitten, get medical help right away.
  • Do not apply a tourniquet.
  • Do not slash the wound with a knife or cut it in any way.
  • Do not try to suck out the venom.
  • Do not apply ice or immerse the wound in water.
  • Do not drink alcohol as a painkiller.
  • Do not take pain relievers (such as aspirin, ibuprofen, naproxen).
  • Do not apply electric shock or folk therapies.

 

References:

  1. Ralph R, Faiz MA, Sharma SK, Ribeiro I, Chappuis F. Managing snakebite. BMJ. 2022 Jan 7;376:e057926. [Medline]
  2. Seifert SA, Armitage JO, Sanchez EE. Snake Envenomation. N Engl J Med. 2022 Jan 6;386(1):68-78. [Medline]

 

Created Jul 28, 2022.

 

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