It is important that every snake bite victim receive first aid treatment
as soon as possible. The patient must not exert himself by running,
because increased circulation brought on by such physical activity will
speed up absorption of the poison. For the same reason, the use of
whiskey or other stimulants should be avoided.
The victim’s state of mind is important; he must promptly be convinced
that his chances for recovery are good—and, indeed, they are. He should
not be terrified by the thought that every snake bite means certain
death. Actually, a survey of case histories shows that with prompt and
proper treatment, only about one or two per cent of all snake bites in
this country are fatal.
There is a considerable difference of opinion about the correct first
aid treatment for poisonous snake bite. The Division of Medical Sciences
of the National Research Council, a section of the National Academy of
Sciences, recently made a study to determine the most effective method
of such treatment. It recommended immobilization of the bitten limb,
application of a constricting band, and prompt incision and suction.
Based on these recommendations, the following first aid treatment for
poisonous snake bite is suggested:
1. IMMOBILIZE THE AFFECTED ARM OR LEG whenever possible. Where this is
not practicable, keep movement of the bitten limb to a minimum.
Muscular activity helps increase the spread of venom. Whenever
feasible, transport the victim by litter to further medical aid.
2. APPLY A CONSTRICTING BAND from two to four inches above the bite,
between the wound and the heart. This will help to limit the spread of
venom until it can be removed by incision and suction or neutralized
by antivenin. A piece of rubber tubing or a strap tourniquet, included
with every snake bite kit, is best for this purpose. When these are
not available, items of clothing may be used. A shoe lace, neckerchief
or a strip of clothing torn from shirt or trousers will do. The
poison, unless injected directly into a major blood vessel or deeply
into a muscle, is absorbed slowly by the lymphatics below the skin.
Therefore, do not restrict the deeper blood circulation by applying
the constricting band too tightly. It should be loose enough for a
finger to be slipped under it with little difficulty. Remember that
during first aid treatment the constricting band must be loosened
every 15 minutes for about two minutes. This precaution may prevent
gangrene. If the bite is on the hand or forearm, take off rings,
bracelets or other jewelry because subsequent swelling may make their
removal difficult.
[Illustration: Applying constricting band]
3. MAKE INCISIONS after sterilizing the cutting instrument and the bite
area with iodine or alcohol. If no antiseptic is available, the blade of
the cutting instrument can be sterilized by holding it over a flame (a
match will do). Make _one_ cut over each fang mark parallel with the
long axis of the bitten limb, not across it. Incisions should be
one-quarter inch long and one-eighth to one-quarter inch deep, but
definitely no longer than the diameter of the suction apparatus being
used. This would allow air to enter the suction bulb from the outside
and the device would then be unable to work. Incisions are of the utmost
importance to first aid treatment; without them little or no poison can
be withdrawn from the wound by suction. However, making even a small
incision involves some risk and this operation should be done with
considerable care. Improper or carelessly applied first aid may actually
do more harm than good. Although a physician may later decide to make
additional incisions to relieve the pressure of swelling, only the cuts
over the fang marks are recommended for first aid.
[Illustration: Making incision]
4. APPLY SUCTION to the cuts. This can best be done with one of the
suction devices manufactured for that purpose but, if none is available,
suction can be applied by mouth. There is little danger in oral suction
unless the lips or inside of the mouth have cuts or abrasions. Contrary
to popular opinion, a tooth cavity will not permit passage of venom into
the blood. Moreover, snake venom is destroyed by the stomach’s digestive
juices, so if some is accidentally swallowed, there is little need to
worry if you have a healthy system. Only during the first 30 minutes
following the bite can much venom be removed by incision and suction.
[Illustration: Applying suction]
[Illustration: Snakebite kit]
5. GET TO MEDICAL AID as soon as possible—but keep in mind that
unnecessary physical exertion is harmful.
Antivenom may be administered soon after first aid has been started, but
this is best left to a doctor. The North American Antisnakebite Serum
made by Wyeth, Inc., of Philadelphia 3, Pennsylvania, is effective
against pit viper bites but is of less value in the treatment of coral
snake poisoning. Because coral snakes cause so few bites in the United
States, no serum to neutralize their venom is prepared in this country.
In South America, where these snakes are common and may reach a length
of five feet, a serum to neutralize the poison is being produced by the
Instituto Butantan at Sao Paulo, Brazil. It and other foreign snake bite
serums often are available at larger zoos where exotic poisonous species
are exhibited.