Before we discuss how to treat a snakebite without medical intervention it is crucial to understand that the ONLY proven way to treat a snakebite with life-threatening consequences is with antivenom at an appropriate medical facility! Without medical help, these snakebite victims will not survive.
However, most snakebites occur when medical help may not be available to you in the workplace, at home, or on holiday and you will have to familiarize yourself with how to treat a snakebite until you can get medical help and have a good quality snakebite first aid kit close at hand. In this blog, we will discuss how to treat a snakebite without medical help until you can get assistance from the Emergency Medical Services or have transported the victim to an appropriate Medical Facility.
1. What are the Correct Steps to Treat a Snakebite?
The skills of how to correctly treat a snakebite could give a snakebite victim some additional time to get to a hospital alive for further treatment. As mentioned earlier a good quality snakebite first aid kit also goes a long way in ensuring you have everything you need to treat a snakebite without medical help close by. Below is a step-by-step guide on how to treat a snakebite but you can also download our Snakebite First Aid Treatment Poster to have it available for a quick reference. When you or someone close to you is bitten by a snake remember the following steps to treat a snakebite:
- Move the victim to safety – Do not assess/treat a snakebite in the area where the snakebite occurred. The snake may still be in the vicinity and a second bite may result in a second casualty!
- Call for Emergency Services – Find out which Emergency Medical Services is the closest to you and get a direct number before you are faced with a snakebite so that a quick response can be ensured for fast evacuation to an appropriate medical facility. National Emergency numbers include 10177 for the Provincial Ambulance Services, 082 911 for Netcare911, and 084 124 for ER24.
- Calm and reassure the victim – When someone is scared and fearing death, they usually breathe faster increasing their heart rate which could hasten the spread of venom around the body. Keep the snakebite victim calm, explain to them that you have a snakebite first aid kit, and know how to treat a snakebite until the Emergency Medical Services arrive.
- Remove any tight-fitting clothing and jewellery – In the event of a snakebite where swelling occurs any tight-fitting clothing or jewellery like bangles, watches or rings could become so tight fitting that it cuts off circulation which could lead to amputations in severe cases. Rather deal with these as soon as possible while they are still easy to remove.
- For neurotoxic bites only apply an elasticated/pressure bandage – These bandages are not supplied with ordinary First Aid kits and Crepe bandages can not provide the required pressure and are therefore ineffective when you treat a snakebite. It is a good idea to invest in a good quality snakebite first aid kit to have in an emergency. If the snake has been 100% identified as a neurotoxic species then apply the bandage from the fingers/toes towards the trunk. It should be applied tight similarly to when a bandage is applied for a sprained ankle. It should be tight enough so that you can manage a single finger underneath the bandage but not two or more.
- The use of a tourniquet – A tourniquet is a hotly debated piece of equipment when you treat a snakebite. However, they do have a narrow indication when you treat a snakebite in South Africa. When the snake has been 100% correctly identified as a Black Mamba or a Cape Cobra, pressure bandages are unavailable, and you are more than 90 minutes from a hospital you may consider a tourniquet. Keep in mind that the use of a tourniquet comes with risks of amputation and multiple organ failure in prolonged use. Do not use things like shoelaces, wire, or thin strips of cloth as it may cause damage to the tissue. Use a purposely made tourniquet or a blood pressure cuff to cut off the arterial circulation. Also do not remove a tourniquet once it has been applied.
- Immobilize the limb and get the victim to an evacuation point – Immobilize the limb to prevent movement which would hasten the spread of venom. Immobilization does not necessarily mean splinting. Splints are bulky to carry around. You can use a crepe bandage and simply bandage an arm to the chest or bandage one leg to the other (if the patient doesn’t need to walk) to immobilize the affected limb. Once this has been done get the patient to a point where he/she can easily be transported by an ambulance or other vehicle.
- Transport the patient to an appropriate medical facility – Not all hospitals are equal. Find out which hospital in your area keeps antivenom and transport patients to these facilities. They may not always have antivenom in stock, but they could arrange to get antivenom or would understand the urgency to get the patient to antivenom if he/she is stable enough to travel. Getting a patient to a rural clinic will be wasting time.
- Paracetamol may be given for pain, if and where indicated – Stay away from opioid pain management when you treat a snakebite as their side effects may mimic some of the symptoms of envenomation. Our snakebite first aid kits do not contain any medication as some people are allergic to medication, please ask the victim if they have any allergies before giving them anything for pain.
- Transport the patient on his/her side in case vomiting occurs – When a patient starts to loose consciousness and vomits, they may aspirate and die. Transport your patient on their left or right side so that the airway remains clear if vomiting occurs.
- Monitor airway and breathing and be ready to resuscitate in a worst-case scenario – Respiratory depression, respiratory arrest, and cardiac arrest are all possibilities in severe cases of neurotoxic envenomations. When you treat a snakebite be aware of this and prepare for the possibility of performing Rescue Breathing or Cardiopulmonary Resuscitation. If you do not know how to do this, you could either join us for a Snake Identification, Handling and Snakebite Treatment training course or just a basic CPR course.
- Rinse out venom in the eyes – If a Spitting Cobra or a Rinkhals has sprayed venom into a victim’s eyes immediately rinse them out with any bland liquid which includes water, milk, urine, or sterile Sodium Chloride.
2. How To Treat A Snakebite in the Bush
When you are in the bush and far from any medical intervention then you have a responsibility to prepare yourself and any staff you may have to deal with a range of different emergencies including how to treat a snakebite. Ensure that you have adequately stocked snakebite first aid kits close by, and make sure that you can get hold of emergency services when the need presents itself.
If you have no equipment and you need to treat a snakebite do not reach for that makeshift tourniquet unless it is indicated as already discussed. Simply keep the patient calm and arrange for quick transportation. If the patient is in a bad state and has medical aid, a private aeromedical helicopter could be dispatched to reduce transportation time.