With the hot weather comes the snakes. Here in Australia we have the second most deadliest snake in the world – the Brown Snake which is responsible for 60% of snake bite deaths here in Oz. The common brown is pretty much every where where people are, as they love feasting on mice and rats.
It is important to know how to deal with snake bites that may be received whilst trekking through the bush or on a hike. As a certified St John Ambulance first aider, that’s why I carry and highly recommend carrying snake bite treatment kits anytime you head out into the bush. If a bite from a venomous snake isn’t treated as soon as possible, the venom can travel through the lymphatic system uninhibited causing death within 4 hours. A snake bite is a medical emergency and it must be treated as such. So the faster you apply snake bite bandages, the greater the chance of the casualty surviving. Act fast but keep calm at the same time (a very difficult task to do!)
Take comfort in the fact that very few people (approximately between 1-4) die in Australia each year from a brown snake bite. Most snake bites will not result in severe envenomation and will not usually require anti-venom although you should always get it checked out by medical staff at a hospital.
There are two types of bites: dry and venomous. A dry bite is when a snake strikes and bites you but no venom is actually released. A dry bite will be rather painful and will cause swelling and redness around the affected area. A venomous bite is obviously where venom is released. You cannot tell if a snake bite is a dry bite so it is always advisable to err on the side of caution and assume that the bite is venomous and treat it as a medical emergency.
Symptoms of a venomous snake bite may include:
- severe pain around the bite (may or may not be present)
- tingling, stinging, burning or abnormal feelings of the skin
- feeling anxious
- nausea (feeling sick) or vomiting (being sick)
- breathing difficulties
- problems swallowing
- stomach pain
- irregular heartbeat
- muscle weakness
- paralysis, coma or death (in the most severe cases).
How to treat a snake bite…
The pressure/immobilisation technique is the best method to treat any snake bite in Australia. This method involves firmly bandaging the arm or leg with compression bandages until an ambulance arrives.
Follow the DRSABCD action plan (detailed in the chart to the left), THEN commence treatment for the snake bite. First check for danger – both to yourself and the patient. Check for a response – squeeze the patient’s shoulders and hands and ask for his/her name. If in a responsive state let the casualty know who you are and that you’re there to help. For example, say “Hi mate, my name is John, I’m a first aider and I’m here to help.” Be calm and reassuring, this will hopefully make the patient calm down.
Next, call 000 and ask for an ambulance to your location. If your location is in a remote area be sure to mention and describe the nearest landmark. If the casualty is in a calm and level headed state, he/she may be able to call the ambulance while you treat the bite otherwise give a friend or bystander the task of calling for medical assistance. In the event that non one else is available or willing to make the call, utilise the speaker phone option so that you can hear and communicate with the ambulance dispatch operator hands free whilst applying first aid. If the patient is unconscious, you should put the patient in the recovery position before calling an ambulance.
Open the patient’s airway by tilting the head back and lifting the chin. Check the mouth for foreign material and if present, first place the casualty in the recover position then clear the airway with your fingers. If no foreign material is present, leave the patient on his/her back and open the airway.
Check for breathing – look, listen and feel. If normal breathing is not present, then ensure an ambulance is enroute and commence CPR (30 chest compressions: 2 breaths; pump the chest hard and fast at a rate of 100 times per minute; continue until you’re relieved by another person or medical help arrives) and if a defibrillator is available, apply it. If the patient is breathing normally, place in the recovery position and monitor breathing. You can now commence treatment of the snake bite.
Assist the casualty to a comfortable sitting position. Minimise movement as movement causes the venom to spread and this is why you must apply compression bandages and immobilise the affected extremity. If the casualty is in imminent danger of the snake, then in that case you should move the casualty away. It is important that you do not try to harass, kill or capture the snake as this can cause further danger to yourself, the casualty and any other bystanders. In most cases, the snake will shoot off into the scrub by itself. If not, just leave it alone.
Next, remove the casualty’s shoe and sock (if the bite is on the leg).
Starting at the fingers or toes, firmly apply the compression bandage as far as possible (normally the upper thigh area or armpit). Use additional bandages if one is not adequate (normally you will need 3 compression bandages for the average adult male leg). Ensure that you stretch the bandage as you wrap it around the casualty’s leg as a loose bandage is ineffective as it must compress the lymph nodes in order to effectively stop the venom travelling upwards.
Be sure to check the circulation of the extremity by squeezing the fingers or toes gently and the colour should normally come back in 3-4 seconds. If the colour comes back in 3-4 seconds, this is a good sign that you haven’t cut off the bloody supply. If you have cut off the blood supply, then remove the bandage(s) slowly and re-apply them at the correct pressure.
Mark the bite site on the outside of the bandage by circling with a pen or Sharpie along with the date and time. This critical information will help the medical staff immensely.
Immobilise the the limb using a sling for an arm or splints for a leg. In a situation where a commercially produced splint is not available, improvise with a large bandanna or a belt.
DO NOT, under any circumstances, apply a tourniquet, cut the wound or suck the venom out of the wound as it can cause further injury to the patient, spread the venom even further and put yourself at unnecessary risk of envenomation. Avoid washing the bite site as the venom left behind can help medical staff identify the snake by simply taking a swab and testing it with a ‘venom detection’ kit.
Prepare for Anaphylactic Shock
To further complicate the emergency, occasionally some people MAY experience a severe allergic reaction within minutes of being bitten which could lead to anaphylatic shock which is very serious and can be fatal.
Symptoms of anaphylactic shock may include:
- swelling of the mouth, throat or tongue
- difficulty swallowing
- difficulty breathing or shortness of breath or wheezing
- difficulty talking
- a rash that may appear anywhere on the body
- itching – usually around your eyes, ears, lips,throat or roof of the mouth
- flushing (feeling hot and red)
- stomach cramps, feeling or being sick
- feeling weak
- collapsing or falling unconscious.
In the event this should occur, call 000 immediately for an ambulance and being administering anaphylactic shock management. Most people who are aware of personal allergies may have some sort of ‘action plan’ and may carry appropriate adrenaline such as an EpiPen or an AnaPen auto injector with them. Assist the casualty with administering their EpiPen or AnaPen making sure to follow the instructions printed on the outside.
As with a lot of other things, use commonsense when out in the bush. If you see a snake, leave it alone and it will leave you alone!