Snake bites on rise

India is estimated to have the highest snakebite mortality in the world. World Health Organization (WHO) estimates place the number of bites to be 83,000 per annum with 11,000 deaths. For instance, each year around 500 – 600 snake bite cases get reported at OGH and in the rainy season, Osmania general hospital Hyderabad gets about 5 – 6 snake bite cases daily and equal number of cases get reported in other tertiary hospital in the city, Gandhi recorded 30 snake bite cases just in July 2017 alone, all these cases are mainly from the neighboring districts and most of these cases seek treatment in Hyderabad due to lack of trained staff and facilities at the district level. Most of the fatalities are due to the victim not reaching the hospital in time where definite treatment can be administered.

Signs of a snake bite are not always visible and, in some cases, the patient may not have felt anything. Depending on the type of snake, signs and symptoms may include some or all of the following:

  Immediate or delayed pain at the bite site

 Paired or single, bite or scratch marks

 Swelling, bruising or local bleeding

 Swollen and tender glands in the groin or armpit of the bitten limb

 Difficulty speaking/ swallowing

 Difficulty breathing

 Drooping eyelids

 Double or blurred vision

 Headache

 Nausea or Vomiting

 Confusion

 Faintness, dizziness

 Limb weakness or paralysis

Most traditional first aid methods should be discouraged: they do more harm than good!

 Unfortunately, most of the traditional, popular, available and affordable first-aid methods have proved to be.

 These methods include: making local incisions or pricks/punctures (“tattooing”) at the site of the bite or in the bitten limb, attempts to suck the venom out of the wound, use of (black) snake stones, tying tight bands (tourniquets) around the limb, electric shock, topical instillation or application of chemicals, herbs or ice packs. Local people may have great confidence in traditional (herbal) treatments, but they must not be allowed to delay medical treatment or to do harm.

 As far as the snake is concerned - do not attempt to kill it as this may be dangerous. However, if the snake has already been killed, it should be taken to the dispensary or hospital with the patient in case it can be identified. However, do not handle the snake with your bare hands as even a severed head can bite!

Recommended first aid steps:

 Reassure the victim that death is not imminent and that medical care is available.

 Reassure that most of the bites are non-venomous.

 Remain calm; make the victim comfortable.

 Control anxiety. Excitement may increase heart rate and blood circulation. This will help spread the venom through your body much faster.

 Lay down flat on the ground; Keep the bitten body part below heart level (do not lift the bitten part above the chest). Any movement or muscular contraction increases absorption of venom into the bloodstream

 Remove shoes, rings, watches, jewelry and tight clothing from bitten area. They may act as a tourniquet in the event swelling occurs.

 Immobilize the victim’s bitten limb in the same way as for a fracture.

 Use bandages or cloth to hold the splints, not to block the blood supply or apply pressure.

 Wash the wound with running water. The running water would remove the overlying superficial venom. Do not use your hand to push the venom out of the wound. It would just complicate the bite area.

  Get the victim to the nearest hospital as soon as possible.

Preventive Measures

 Keep plants away from your doors and windows. Snakes like cover and plants help them climb up and into windows

 Keep animal feed and rubbish away from your house as they attract rats and snakes will follow.

 When walking at night always use a torch.

 Wear boots, long-sleeved shirts and long pants

 When walking, walk with a heavy step as snakes can detect vibration and will move away.

 Carry a stick when grass cutting or picking fruit or vegetables or clearing the base of trees.

 If collecting grass that has previously been cut and placed in a pile, disturb the grass with the stick before picking the grass up

 Give the snake chance to move away.

Time between snake-bite and treatment

 If snake venom is intravenously injected, instantaneous death may occur.

 Otherwise in actual snakebite cases it varies with different families of snakes and ranges from 12 minutes to more than 72 hours.

 Remember, although you would have more than three or four hours before your condition becomes life threatening, quicker the treatment, lesser the complications.