Snake Safety : bitten by a snake — what you do next could save your life

You have just been bitten by a small snake. You are pretty certain it is just a harmless snake, but it disappeared before you could get a proper look. Do you administer first aid and go to the hospital or keep gardening or what ever it is you were doing and ignore it?

The Flying Doctors Update their  advice as incorrect identification is common

Between 2005 and 2015, eastern browns were responsible for 17 of the 23 snake bite deaths in Australia, with most victims dying from out-of-hospital cardiac arrest or bleeding on the brain.

Of the 296 eastern brown snake bites in that period, 18 per cent caused acute kidney injury, and other ongoing complications were common.

Although they typically only inject a small amount, hatchling eastern brown snake venom is capable of killing an adult, so being bitten by a small snake does not mean it is harmless.

Adding to the difficulty, eastern browns range from red-brown to black or grey, can be striped, mottled or have a reddish band behind the head, and can look very similar to other harmless species.

The Royal Flying Doctor Service (RFDS) no longer advises bite victims to attempt to identify the snake after a paper published in the Medical Journal of Australia (MJA) in July found that snake identification was unreliable for people presenting to hospital with bites.

When the ambulance arrived , they replaced the improvised compression bandage before transferring the patient to hospital.

"They tried doing swabs to see what sort of snake it was and they couldn't [tell] because I had to wash it to see if I was actually bitten," said the patient .

"So yeah, I did the wrong thing there but at the end of the day I needed to see if I'd actually been bitten as well."

Several swabs did not reveal any venom, so the hospital removed the patients bandages and began to monitor  blood pressure, coherence and pupil dilation.

At this point there was no way of knowing if he had been bitten by a mildly venomous snake, a highly venomous snake that had only injected a very small amount of venom, or a highly venomous snake that had injected enough venom to be fatal.

Because he put a pressure bandage on the limb and got to the hospital with a generic polyvalent antivenom on standby, in every scenario the patient  is likely to make a full recovery.

But if you had kept gardening, in the third scenario you could have been dead in under half an hour.

As it was, the patient was kept at the hospital and monitored hourly through the night.

Finally discharged the next day as the symptoms began to improve, although the species of snake that bit the patient was not able to be identified.

Dr Fry's advice is to always get to the hospital, even when you think you know the species of snake.

"It's better to be there and not need to be there, than not be there and really need to be there."

RFDS updated guidelines for treating snake bites

  • Do NOT wash the area of the bite or try to suck out the venom. It is extremely important to retain traces of venom for use with venom identification kits.
  • Do NOT incise or cut the bite, or apply a high tourniquet. Cutting or incising the bite won't help. High tourniquets are ineffective and can be fatal if released.
  • Do bandage firmly, splint and immobilise to stop the spread of venom. All the major medical associations recommend slowing the spread of venom by placing a folded pad over the bite area and then applying a firm bandage. It should not stop blood flow to the limb or congest the veins. Only remove the bandage in a medical facility, as the release of pressure will cause a rapid flow of venom through the bloodstream.
  • Do NOT allow the victim to walk or move their limbs. Use a splint or sling to minimise all limb movement. Put the patient on a stretcher or bring transportation to the patient.
  • Do seek medical help immediately as the venom can cause severe damage to health and even death within a few hours.

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