A Discussion of Traditional Snake Bite Treatment
by Bayou Bob, circa, 1997
One of the most painful and excruciating injuries that can occur to an individual is that of a venomous snake bite. There is very little good news when it comes to this situation. It helps somewhat to learn that many times even the most toxic of snakes may not inject venom. This may be a choice made by the snake as in not being angered, not threatened, nor in pain. It may be a previously injured snake with no venom available or one that had just completed a serious eating binge wherein most poison was used up. At any rate, the fact is that a significant proportion of bites do not result in any envenomation! That is probably the only really good news about snake bites! The other point in such a discussion which needs to be made is that very few bites occur totally as an accident. This means that most victims actually were aware that the snake was present before they were bitten. The obvious point here is that the bite victim most often chose to behave in a manner that ultimately resulted in a bite. So many people feel it is their duty when they spot a snake to hit it, throw a rock at it, try to catch or kill it, or some other non-evasive action. They could have simply walked away and left everything as they happened upon it! Most snake bites can, in fact, be avoided with very little extra effort and thought.
Most snakes are defensive animals. They prefer to be left alone and will go to great lengths to prevent contact. Their main interests seem to be eating and otherwise surviving without any human contact if possible. When provoked, startled, or threatened, many snakes will prepare to first take flight, then fight if given no alternative out. It is when they utilize their poison in this mode that creates the crisis of a snake bite! These reptiles use the system which they have been provided as their defense in an effective manner. They are good at what they do because they practice it daily in routine survival skills throughout their life cycle. The best approach then in relating to the poisonous species of snakes is based firmly in a better understanding of the behaviors, the critical environmental factors, and the general characteristics of each dangerous snake possibly to be encountered in a geographic area. Avoiding bites seems to be a natural outgrowth and simple result of this increased knowledge level.
When the unfortunate does happen and a bite is suddenly present, what are the earliest symptoms? In order to better understand this assured set of rapidly oncoming symptoms, we need to know what the venom is designed to do. Very simply put, it is a central part of a highly developed food acquisition system. The hemotoxic snake has venom within its special glands to promote a stunning of prey, a predigestive function to trigger a softening and desolving effect upon meat tissue, and in certain species aids as a tracking feature to assist at final location of mortally wounded victims. In short, this chemical material is an awesomely destructive complex compound targeted at some very serious chores dedicated toward the snake's survival. It will cause major problems when introduced to the fluids of warm blooded animals. This can be a mouse food item or a lower human leg, the venom does not appreciate the difference. It sets about to do its duty with little respect toward the nature or comfort of the victim. It can be very bad and very painful to go through what we are describing while fully feeling and aware of the occurrences. A serious snake bite is an ugly thing to watch as it takes its course.
Now let us get off into more of the expected bite-related effects and some actual treatment possibilities. First, in a more serious bite from a hemotoxic species, there will often be free bleeding in the wound marks. This is due to the anticoagulation effect of the venom and turns ordinarily thick blood into a watery consistency. There will seldom be a pair of clean matched puncture wounds. Often there is a series of cuts and scratches, predominated by at least one fang entry wound. Very quickly, there will be a burning sensation, at first just bothersome, then rapidly graduating to severe pain. It is this aspect which supports a dose of fear, some irrational decisions, and overall panic. Swelling is the next complication so frequently present. This can be the real damaging symptom. It may progress for many hours and cause serious restrictions in circulation, along with pressure-related injury to local tissues. The bite becomes a spiraling series of increasing complications and stress inducing, almost overwhelming pain. Things may go unabated for hours or days as the body's reaction and tolerance levels attempt to deal with the attack. Later symptoms include such matters as massive infection from some really strange and strong bacteria, necrotic tissue areas, huge edema or fluid buildups, extreme skin and neural sensitivity, inability to rest properly, and a host of other problems. Even early on, the misery associated with a serious bite is very difficult to outline thoroughly enough that the untested can fully appreciate the consequences! Without proper first aid, though, the bite will most assuredly be more intense and damaging! All of this description is designed to bolster the fact that most people should go out of their way to apply good field principles and avoid encounters where the snake has the upper hand.
The fact that there are some control factors that can be applied will help. Still, looking back on a bite where venom was present, the victim can readily see that there is not much good involved in a bite. The bite itself can be devastating even well short of fatal, but the treatment has little more to offer in the way of comfort either. The rapid application of certain first aid principles can be the real difference in successful prognosis of what the effects and outcome will be. A bad bite can last a lifetime - both physically and psychologically! Early treatment by proper technique choice may alleviate some of the very bottom of the worst associated symptoms. It is best not to bottom out when we are discussing what a serious bite is like. In general, any reasonable action which supports the common sense basic need to assist with these symptom types without adding further complications to interfere with later medical services is likely useful to apply.
It seems that there are several first aid processes which are regarded as more traditional approaches to bite treatment. These are referred to as either the 'cut and suck' method, the 'cold pack' method, or the more medical associated process of utilizing antivenin. This latter is not recommended as a self-induced early first aid. Such powerful serums may have powerful side effects which could prove difficult to deal with in a first aid situation. Remember, all of these treatments can be potentially as devastating as the bite, so be sure to rehearse the eventuality of a bite and improve the likelihood of making the right decisions in a rapid manner under a very poor near frantic planning environment! Calm and reason rarely go hand in hand at the initial bite scene! Review each approach for what it has to offer and what fits the individual circumstance the best. Perhaps it can be shown that a rational combination of the positive aspects of each of these traditional approaches can be seen to have the best efficacy.
The cut and suck approach relies on a quick series of actions. First, identification of the snake species is paramount if easily accomplished. To treat a bite with this approach when the snake was not dangerous is a very negative experience! It is important, though, to treat all bites as if they are from a poisonous snake, then try to work quickly to disprove the reality if possible. A light restricting band both above and below the bite area is important. This is designed to slow down the flow of body fluids, especially the lymphatic system and near-surface fluids which assist at spreading the venom. This should be appropriate to the size of the bite area and several inches away so as not to interfere with application of the further treatment components. The choice of material for this band is less important than being sure not to make it so tight as to completely restrict blood flow, assuring this by being able to force two fingers under the bands. Do not use a tourniquet! Next, with a short sharp blade make incisions across the main wound area. From this spot, the application of suction will be made in a critical effort to remove even the slightest trace of venom that it can reach. This enzyme-based poison is ravenous and works against the tissues very quickly. Speed is paramount and suction must be accomplished without delay! The suction devise is important only in that it must be readily available and ample at producing suction enough to pull fluids back out of the wounds. This may be the human mouth or some mechanical device. The venom is not harmful to the mouth. It has no taste and no odor. It is dangerous only when in contact with body fluids. A person can ingest this substance without any concern. It can come into contact with surface skin without concern, and there are numerous examples of various incidents where such intense contact and ingestion have resulted in absolutely no symptoms. As a matter of course, though, this is a mouth-produced, non-sterile fluid which may contain any number of less appealing elements or bacteria that could make for complications, so it should be avoided at best if possible. If the situation dictates that mouth suction is the only available alternative, then the opposing likely complications of not using such suction definitely justify its quick utilization. Cleanse the area with a sterile antiseptic early on and continuously. Suck as often and as much as possible even during transport time. There is a significant reduction in any efficacy or success in extracting venom after an interval of only fifteen minutes or so. Then transport safely to the nearest likely prepared medical service unit. Many of the older reference materials to this approach add the various aspects of seeing that the victim remains calm, rests, maintains elevated leg position, is treated for shock, and kept warm, etc. and other prompts. In reality, many bites occur while the victim is alone, very far afield, or is otherwise not prepared with a quality first aid snake bite kit. The main concern is to seek to remove some venom as quickly as possible. Sterilize to the extent practical and remove to further assistance or support areas.
As mentioned, all treatment approaches have negative consequences too. The important downside of the cut and suck method centers around the cut part. This is difficult to accomplish in a good situation, but is almost impossible to achieve at a useful level if there is any squeamish person involved either as victim or first aid administrator. The blade used has a common sense formula also in that the larger the blade, the deeper the cut; hence, the more potential for serious tissue damage. Fortunately, much of what nature put there in the forms of vessels, nerves, veins, tendons, ligaments, muscles, organs, and the like are placed deep enough that the superficial type cuts over such a wound do not often place the victim in harm's way. Nevertheless, treatment that involves a cut should consider location and depth factors foremost! The other down side to this technique involves the fact that a set of improper cuts may actually accelerate the spread of venom. Instead of impeding this process and enabling effective suction, blood flow and increased contact with the chemical venom may be to the detriment of appropriate action. There are many theories on this, yet again, common sense seems to suggest that perhaps there are several significant negatives as related to this method. There will be more on this later as support for an actual combination of earlier developed treatments seems to evolve. The history of this cut and suck method goes way back and many a snake bite has been treated in this fashion. Likely, too, the sum total of the spin off extensive damage of all these first aid applications with this approach could be quite overwhelming.
The other predominant treatment approach sometimes referred to as the 'cold pack' method seems to be similarly situated in that portions of the applied method may contribute to a better overall first aid technique which departs from the basics of this rather simple notion. In the cold treatment approach, the bite is simply cleansed and a cold compress is positioned directly over the wound. There have been several commercial artificial cold packs developed which are designed to simulate icing and may be utilized where this application is prescribed. The main action theme is quick application of ice or very cold pack, followed by safe transport to a valid medical facility. While this method gets away from many complications, it also comes with some downside. The tremendous burning associated with venom seems to be alleviated through the use of a cold compress. This is comforting to the victim who may not be willing to suffer the removal of the cold sensation and thus may actually cause tissue damage beyond that expected from the bite. It is important to periodically change surface areas with the cold pack for this reason. The whole approach is based upon the supposition that the cooler body temperature in the local bite area will have somewhat reduced circulation and spread of venom, and further, that swelling seen as the worst symptom to deal with may be checked or reduced during transport time. The successful application of this technique has its proponents and they support it well with testimonials. The downside alone of not at least attempting some form of immediate venom removal, coupled with the potential for complicating the surface tissue damage situation may support the combination approach which this discussion is building toward.
Another referenced approach which may hold merit as a first aid process involves the use of antivenin or snake bite serum. There are those who maintain snake collections where the keeping in stock of some specific application antivenins represents the base first aid approach. This is likely not to be the case in a field environment where an individual confronts a bite. This latter factor minimizes the significance of this approach as a viable alternative first aid for the average outdoor enthusiast or sportsman. Still, the life saving potential of this approach when it involves certain megatoxic species may justify the pharmacy stock of this substance. It needs mention even though the average citizen is not going to have access to this material. The use of antivenin has some very important aspects which may contribute to our continued building block of treatment based on the most useful aspects of several earlier stand alone approaches to bite first aid. The serum method involves injection or IV drip of a species specific antivenin in a dosage carefully determined by mass and observed progressing complications. There is much risk. This must be seen more as a treatment application at the final site of competent medical services rather than as a common first aid. The antivenin works to combat the poison within the system and has some very evident potentially hazardous downside features. Side effects like breathing difficulty, organ damage, extreme hives, and much more may be enough to make all victims aware that they should be located near where certain sophisticated items of emergency support equipment are readily available. The side effects may actually be evaluated to be of insignificance in comparison to an obvious severe bite with serious observable onset of complications. The application of antivenin may, in fact, be to address what has been determined to be a life or death matter. In this case, the treating of any side effects becomes incidental to survival first. The approach of applying antitoxins should likely be left in the hands of true trained professionals - but its contribution at the appropriate time in the treatment sequence of an overall process may be shown to be quite useful.
The electroshock treatment is among the newer methods reported at achieving reasonable success in bite treatment. This is not yet considered traditional even though the earliest reports of application date quite some time back. These were not United States based field experiences and were thus less likely to end up as being counted as having moved through the time tested process of being considered traditional first aid. Still, the potentials for successful first aid reported in this area have been quite impressive. The book may continue to be open on this matter, but the approach itself, like the others, may present a contribution to an overall process that seeks out the best results. In this approach, the direct application of electric current to the bite locale is the central focus. Various presentations deliver this shock in different manners. The theory seems to rest in the basis of a very high voltage thrust at a very low amperage. Now, it is evident that whenever the application of electricity to live tissue is involved, there are some strong considerations to keep in mind. Just how much voltage is high enough? What is low amperage? Where and how often is this applied? These are serious questions and all need to be played out to establish some base line formulas for treatment. Research is still underway seeking to outline these parameters. Some people foolishly assume that since electricity is so widely utilized in the medical field for a very wide range of treatment and testing purposes, it surely cannot be that complicated to apply the principles to snake bite first aid. Anytime that high voltage, poor field conditions, a dose of frantic panic, severe pain, and the like are a part of the situation, great care should be placed upon decision making to use this technique. Yet, as a method of first aid it has much to offer and cannot be discounted due to the downside characteristics. The same principles applied to the other methods must be applied here as well.
Generally, it is accepted that DC current is more suitable for the method. This means stay away from electric plug in receptacles in a wall somewhere! The proper current can be obtained from older coil based gasoline engine ignition systems. Things such as outboard motors, lawn mowers, car or jeep engines, and the like have been pressed into service. There are currently small modified versions of the stun gun which are touted as being effective portable units sufficient to deliver the necessary shock. The idea is to hit the area with enough voltage to damage the cellular molecules of the venom. This must be accomplished at the same time that low enough amps are used to prevent tissue burning, organ damage, convulsions, and a host of other possibilities being experienced from uncontrolled voltage. This is definitely a precision approach with seeing to it that proper safeguards are being maintained. Past successes have reported that voltage in the 100K level coupled with amps at the 1 or 2 level seem to be workable. The bite area is tapped quickly in one second bursts of six or seven spots in a circular fashion around the wound. Earlier taps are closer in an effort to logically reach venom before it spreads farther out. As time in minutes progresses and swelling or other symptoms move outward, the electric taps move outward also. It has been reported that beginning immediately with the bite itself in time, a series of taps every 10 to 15 minutes for the first hour may work to reduce the impact of the venom. It should be obvious that having ready access to such a shock source is a central feature of this approach. To expend hours seeking out or building a power source is not practical. The idea in all treatments is to respond to the presence of the poison very rapidly! The sooner some can be removed, or in the case of this latter treatment, be damaged in some way, the less likely the onset or the lower the peak of some of the more negative symptoms. It is widely held that the shock properly accomplished has the direct effect of changing the shape of the venom cell such that the adhering quality to whole blood cells is reduced, thereby rendering at least a portion of the venom less able to produce the designed results. As a first aid tool, this approach also must be coupled with safe transport to competent medical service. Additionally, antiseptic procedures should be applied throughout as practical. The history of this approach is more limited but it certainly makes up for late ground by holding the most dramatic claims for rapid success in treatment with minimal resulting damage levels. This method requires a deeper investigative effort and such a continuing study is supported with great hope by those who have experienced the pain of a bite with all of the negatives associated with other treatment courses.
In summary, it is becoming evident to some field practitioners that a first aid approach combining selected qualities of all the above may actually hold the most potential for a final solution until a final solution is discovered. We should likely never give up the idea of progress by becoming frozen to one approach! This discussion ends with a reference to the effort to create and state a combination first aid approach for snake bite treatment. This referenced work is designed to be potentially useful in emergency bite scene applications. It is a ready reference for those who plan ahead, and it may be quickly used by those who suddenly confront a bite situation if they are lucky enough to have a copy with them. No medical claims are made and a solid referral to appropriate treatment must be coupled with any such first aid. The best that first aid can do is retard the venom effects, prepare the victim for further treatment, and avoid complicating matters as much as possible. The best first aid cannot deal with necessary antibiotics, required surgery, special testing, anesthetics, and a host of other medical services which will almost always be a part of a serious bite. The best first aid is that which works quickly and effectively under the conditions present with the tools available! A firm command of the situation by all present with no room for timidity and some appreciation for a logical treatment plan given the nature of bite logistics is probably the best start that any victim could hope for at such a dire time. Once again, having the knowledge-based approach to dealing with these matters is far superior to guess work or panic. Such a valued position does require effort, planning, practice, and forethought. It does not just happen.....and neither do most bites! Read, learn, watch, think, and become comfortable with this real area of life in almost any area of America or the balance of the world where we see poisonous snakes of many species. On any given day and in almost every area, the possibility of encountering a snake is more real than most want to accept! Be aware of the dynamics involved and reduce or minimize problems to their rightful position of being of little or no concern in interfering with our enjoyment of the great outdoors! Hopefully, this special discussion may play a positive role in moving many individuals to this position! See our ready reference section on snake bite first aid - print yourself a copy! If you need more information, seek out our books, videos and other materials produced to support the knowledge base on snakes in general and bites specifically.
This brief discussion cannot take into consideration all of the many variables and factors implicated in the complex event of a bite and follow-up treatment.
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|Authored by CONCISE COMMUNICATIONS. This page last updated on 05/10/97.
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