SNAKE BITE AND
IT’S MANAGEMENT
INTRODUCTION
• Snakes are cold blooded limbless vertebrates
• Class- Reptaila which also includes lizards,crocodiles,tortise etc
• There are atleast 3000 species of snakes
• 400 are poisonus and most are non poisonous.
Objectives
1. To Identify the Poisonous snakes and non poisonous snakes.
2. To know difference between Poisonus and non poisonus snakes and
bite
3. To know how to manage snake bite
4. To know how to prevent from the snake bite
CLASSIFICATION OF SNAKES
1. Venoumous snakes (poisonous)
2. Non venomous (non poisonous)
Major Venoumous snakes in India
• About 52 poisonous species in india that belong to 3
different families
1. ELAPIDAE : Includes Common Cobra, King Cobra and Krait.
2. VIPERIDAE: includes Russell’s Viper, Pit Viper, Scaled Viper
3. HYDROPHIDAE: sea snakes
However majority of bites are King cobra, Common Cobra,
Russell’s viper, Krait,Sas scaled viper
TYPES
1. Haemotoxic : activates clotting factors, severe swelling with oozing
of blood
. Functional disturbunces like Convulsions,intracerebral
haemorrhage. Example: Viperidae
2. Neurotoxic : most less local symptoms, affects remote nerves,
Pain ,swelling
Example: Krait
3. Myotoxic: myoglobin seen in urine
affects muscles causing rigidity,stiffness,paralysis.
Example: Sea snakes
KING COBRA
KRAIT
RUSSELL’S VIPER
SAW SCALED VIPER
Difference between Poisonous and Non
poisonous
• POISONOUS • NON POISONOUS
• Poison presnt in Salivary gland • Poison ablsent
• Saliva:contains toxic peptides • Saliva non toxic
and enzymes • Tail rounded
• Tail:Compressed • Vertebral scale not so enlarged
• Vertebral scales:enlarged as in • Head scales usually larger
kraits
• Bite marks usually more than
• Head:usually smaller two
• Bites marks: usually two
NON POISONOUS SNAKES IN BRIEF
• Non-venomous snakes have teeth, just like the venomous variety.
• So even in the case of a bite from a non-venomous snake you should
still take special care and watch for infections.
• Bites from large non-venomous snakes can also be devastating - some
large python and boas are able to cause massive lacerations that
require urgent medical care.
LOCAL SYMPTOMS
• In case of KRAITS and COBRA
1. General intoxiation is soon followed by sense of creeping paralysis
beginning in yhe legs and ascending to head by way of trunk.
2. Paralysis of eyelids,incoordination of speech,paralysis of limbs
3. Nausea vomitings frequently
4. Breathing gets more difficulty and finally stops.
5. In krait poisonings in addition to these convulsions and violent
abdominal pain due to internal haemorrhages.
In case of VIPER BITE that is Russell’s viper and saw scaled viper
1. There is a great persistent pain and intensive swelling at the site of
bite
2. Shock,spontaneous haemorrhage in organs and tissues,acute
necrosis and death.
3. Constant oozing of blood from punctures
4. Constitutional symps are both external and internal haemorrhages
in abdomen are responsible for pain,tenderness, vomiting
5. Dearth due to heart failure.
SNAKE BITE MANAGEMENT
To allay anxiety and fear
• Precention of spread of venom
• Anti venom treatment – taken under guidence of doctors
FIRST AID
• Reassurance of the victim
• Do not tamper with bite wound, except wipe with a damp cloth to
remove the venom lying on the skin surface.
• Immobalisation of bitten limb
• Transport patient to hospital immediately
• Do not suck the blood out by mouth
• Do not use vaccum pump or syringe to suck out the blood.
• Do not apply bandage or tornequets ligatures unkess snake os neuro
toxic and myotoxic
• If tornequet is tied it should be released only after anti venom
treatment
SOME DISADVANTAGES OF
TORNEQUET
• Ischemia ang Gangrene
• Damage to superficial perpheral nerves,especially the lateral poplitial
nerve at the neck of febula.
• Congestion,swelling andincreased bleeding from the occluded limb.
• Shock on releasing a tight tourniquet.
ANTI VENOM TREATMENT
• Anti venom is not always necessary;many patients are bitten by
non venomous snakes.
• Antivenom is expensive,always in short supply,and has a limited
shelf life.
• INDICATIONS
1. Haemostatic disturbances; spontaneous systemic
bleeding(gums,epitaxis),coagulopathy.
2. Cardiovascular abnormalities: Shock,hypotension,abnormal
ECG, arrhythmia,cardiac failure.
3. Neurotoxicity,Impaired Consciousness
CONTRAINDICATION
1. There os no absolute contra indication to antivenom
2. Patients with Asthama,fever,veneral conjuctivitis,eczema,food drug
allergies can have increased risk.
3. If in that condition pretreatment with anti histamines IV and
adrenaline subcutaneous may prevent
Timing of anti venom
• Given as soon as the signs of systemic or local envenomation is
evidenced,average time
1. COBRAS – 8 hours
2. RUSSELL’S VIPER- 3days
ANTIVENOM SPECIFICITY
• Has 2 varieties
1. Monovalent antivenom
2. Polyvalent antivenom
• Preferably given IV 5ml/min or diluted in Isotonic fluid.
• Injection of antivenom given into fang marks is ineffective and painful.
Availability of antivenom in India
• Only polyvalent antivenom is available in india .
1. Haffkin’s institute, Mumbai and
2. Centarl Reasearch Institute Kasauli
3. King’s Institute,Chennai
4. Serum Institute,Pune.
• It can neutralize venom of cobra,common kraits,russel’s viper
• Effective when given whithin 4 hours of biting.
• It should be dissolved in normal saline or distil water before use.
• Use only if solution is clear ,if it is opaque, it is not potent.
