What to do if bitten by a viper?

First aid for snake bites

In Belarus there is a common viper, the poison of which causes severe poisoning of the body in humans. Most often, snakes bite the arms or legs. Fatalities after a reptile bite are quite rare in our country. They are more often observed in children and elderly people who have a weakened immune system, as well as in cases of improper first aid and further treatment.

After a viper bite, two small wounds remain on the body, in which the blood quickly coagulates. The tissue around the bite turns blue. Signs of a general reaction usually appear within 15 to 20 minutes. These include general malaise, fever, drop in blood pressure, chills, nausea or vomiting, respiratory and cardiac problems. The viper's venom destroys red blood cells in the blood and, spreading throughout the body, has a detrimental effect on the kidneys, liver, and spleen. Under the influence of neurotropic cytotoxins, which are part of the poison, nerve cells are damaged. Other substances provoke blood clotting, tissue necrosis, and swelling.

Also, after a snake bite, hemorrhages form in different places of the body. If the upper extremities are affected, there is large swelling that can extend from the fingertips to the elbow.

The worst thing to do in such a situation is to panic. As quickly as possible, you need to call an ambulance or take the person yourself to a medical facility, where he will be injected with a special serum against snake venom. And first - provide first aid.

What to do if bitten by a snake

1. Place the bitten person horizontally and ensure rest.
2. Give the victim 2-3 tablets of an antihistamine.
3. Very carefully suck out the venom from the wound with your mouth, while simultaneously massaging the bitten area with movements directed towards the wounds. If this is done in the first 5 to 7 minutes, up to 40% of the poison can be removed. The bloody liquid should be spat out as often as possible. After completing the procedure, rinse your mouth thoroughly with a solution of potassium permanganate (if available) or plain water. Important! If there are wounds in the oral cavity, sucking out the poison with your mouth is prohibited.
4. If the first signs of edema appear, sucking the poison should be stopped and treated with antiseptics. It is not advisable to use brilliant green so as not to complicate the examination of the wound by a specialist.
5. Apply a sterile bandage to the affected area. As swelling develops, gradually loosen it so that it does not cut into the soft tissue.
6. Provide rest to the injured part of the body.
7. Give plenty of fluids. It helps normalize water-salt balance and remove poison from tissues.

What not to do

1. Cauterize the bite site with hot objects or treat it with random substances. For example, kerosene or gasoline.
2. Apply a tourniquet above the bitten area. It will cause blood stagnation and tissue necrosis. Gangrene may develop.
3. Inject wounds with medications.
4. Drink alcohol. They will enhance the effect of the poison and slow down the removal of toxins from the body.

To ensure that nothing bad happens to you while walking in the forest, outside the city or while traveling, you need to follow simple precautions.

• If you are going to areas where snakes may be found, wear boots or other high shoes.
• Dress in closed, tight clothes.
• Be careful while on vacation. Before stepping into thick grass, check it with a long stick. Do not fumble with your bare hands in holes and crevices, or turn over old logs and logs. After all, the expression “underwater snake” has spread for a reason.
• If you see a snake, do not approach it under any circumstances, do not try to throw anything at it or chase it. Experts also recommend not moving until the snake crawls away. And if it suddenly starts to approach, retreat slowly, without sudden movements. You can’t run away, because there may be other snakes nearby.

Deputy Chief Physician for Organizational and Methodological Work Denisova L.V.

Poisoning by snake venom is studied by such a branch of medicine as clinical toxicology, and not only doctors, but also those who work in the agricultural industry, are often outdoors or travel, should have information about the rules for carrying out emergency measures and methods for preventing snake bites.

Every year, about 2 million people suffer from snake bites, of which about 110-120 thousand people die. In Europe these are isolated cases, in the USA there are about 15 people, and in countries such as India, Brazil and Burma the figure is the highest in the world.

On the territory of Russia, the Republic of Belarus and Ukraine, there are about 11 species of poisonous snakes that are dangerous to people.

The most common families are: colubrids, slates, vipers and pitfalls.

Many snakes are not at all dangerous to people, are not aggressive and attack only when a person is deliberately aggressive. Their poison is secreted from a tooth, which is located deep in the mouth and affects only the victim located in the reptile’s mouth.

The situation is different with vipers and other types of poisonous snakes: they are always aggressive towards any human intrusion into their habitat.

To provoke an attack on their part, the mere presence of a person or animal is enough.

That is why in their habitats you should behave extremely carefully and immediately avoid any reptile you see. There are also cases when the moment of a snake bite remains unnoticed until the first signs of poisoning appear or traces of skin penetration are detected.

The Aspid family is represented on the territory of Russia by only one species - the Central Asian cobra, the Viper family - by various species of vipers, ephids and vipers, and the pit viper family - by the common and oriental copperhead.

The greatest likelihood of encountering viper, copperhead, sand ephemeral and some species of vipers (Caucasian, Radde, big-nosed) is observed in the Transcaucasus and Central Asia, and an encounter with the Central Asian cobra can occur in Turkmenistan, Tajikistan and southern Uzbekistan.

In addition to land poisonous snakes, there are also marine varieties of these reptiles dangerous to humans. You can meet them in the coastal waters of tropical seas.

Snake venom is a complex substance, which consists of a set of proteins and biologically active components that have an indirect or direct toxic effect on human systems and organs.

Typically, a snake attacks a person or animal only in self-defense, and about 70% of bites occur on the legs. The aggressiveness of snakes increases during the mating season or molting, but the fact of a snake bite does not always cause poisoning of the body. For example, when bitten by a viper, the snake does not release venom in 25% of cases, while coral snakes and cobras do so in about 50%.

The most severe poisoning by snake venom occurs during alcohol intoxication, high air temperature, in children, women, people with concomitant diseases, people with low body weight and when the poison is injected into the neck, head or large blood vessel.

And the most dangerous are the bites of large snakes.

The most dangerous bite for humans is the bite of the black mamba, which lives in the central, eastern and southern parts of the African continent. During an attack, this snake can reach speeds of up to 20 km per hour and death after its bite is observed in 95-100% of cases.

In this article we will introduce you to the symptoms of poisoning and bites of some poisonous snakes, methods of their prevention and methods of first aid and treatment.

Symptoms of snake bites and snake venom poisoning

The severity and nature of symptoms from snake bites can be characterized by some common features, since snake venoms contain the same components that have similar effects on the human body.

These toxins include the following:

• neurotoxin – affects and causes dysfunction of the nervous system;
• cholinesterase is an enzyme that causes disruption of the transmission of nerve impulses from nerves to muscles;
• cardiotoxin – affects and causes disorders in the functioning of the cardiovascular system;
• hemolysin - provokes the destruction of blood cells and red blood cells.

Symptoms that appear in a victim after a snake bite can be divided into:

1. general - appear when bitten by any poisonous snake and are expressed with varying degrees of intensity;
2. specific - characteristic of poisoning by a certain type of snake venom.

General symptoms

Common symptoms of snake bites and poisoning include:

Local signs. One or two triangular-shaped wounds are identified on the skin. They measure about 2-3 mm and are located on the same level. In the area of ​​the bite, the following signs of inflammation are detected: redness, swelling and burning sensations and pain. The wounds may produce bloody discharge, and the skin surrounding the bite site may have hemorrhages or bluish spots.

General reactions. The victim's temperature rises (to high levels), muscle pain, nausea, vomiting and loose stools with blood appear. Renal and hepatic failure gradually increases.

Neurological disorders. The victim experiences a feeling of muscle weakness, confusion, numbness (especially in the bite area), headaches, decreased visual acuity, double vision, inability to focus, distortion of the facial muscles, drooping eyelids and impaired swallowing.

Cardiovascular disorders . The victim’s pulse quickens, blood pressure decreases or increases (sometimes to critical levels), breathing quickens and pain appears in the heart and chest.

The severity of symptoms of snake venom poisoning depends on many factors:

— The behavior of the victim after the bite. Running, fast movements, walking or panicking accelerate the rate at which the poison spreads throughout the body.

— Type of snake, its size and age. The most dangerous are the bites of rattlesnakes, adders and cobras, less so are the bites of snakes of the viper family, but they can also cause serious deviations and death (in 1% of cases). Poisoning from young or small snakes is less dangerous. In addition, the toxicity of the venom can also be influenced by the degree of fear of the snake before the attack: the more frightened and aggressive the snake is, the more toxic its venom becomes.

— Localization of the bite. Symptoms of poisoning develop more quickly when a bite is applied to the head, neck, torso and large blood vessels. When the lower extremities are affected, symptoms develop more slowly.

— Age and general health of the victim. Children, elderly people, women and people suffering from serious illnesses or under the influence of alcohol are more susceptible to snake venom toxins. In such cases, death can occur at lightning speed.

— The presence of pathogenic bacteria on the snake’s teeth. Wound infection can cause the development of severe purulent complications, necrotic processes and sepsis.

— High air temperature. A hot climate promotes faster blood flow through the vessels and the spread of poison.

All these factors contribute to the increase and progression of the general symptoms of snake venom poisoning. Depending on their combination and severity, the signs of poisoning can be aggravated by layering on each other or immediately causing the development of a shock reaction and the rapid onset of death of the victim.

Symptoms of a viper bite

The viper's venom contains enzymes that are toxic to the human body, such as:

• phospholipase;
• hyaluronidase.

Viper venom destroys the walls of capillaries and blood vessels, red blood cells, forms blood clots and causes circulatory disorders. Under its influence, the water-mineral balance and the activity of the cardiovascular system and liver are disrupted.

A victim of a viper bite experiences the following symptoms:

• 1 or 2 wounds from biting the skin with teeth, relatively mild pain, swelling that appears after 10-30 minutes, redness, burning, areas of hemorrhage, purple-bluish spots and areas of skin necrosis at the site of the bite;
• dizziness and headache;
• tachycardia;
• decrease in body temperature and fever as symptoms of poisoning increase;
• pallor;
• weakness;
• drowsiness;
• confusion or fainting;
• nausea;
• sweating;
• dyspnea;
• development of renal failure.

Symptoms of the bite of the Central Asian cobra and other snakes of the slate family

The venom of the Central Asian cobra includes:

• neurotoxin;
• cardiotoxin;
• hyaluronidase;
• phospholipase;
• cholinesterase.

A victim of a bite from a Central Asian cobra or other snakes from the slate family experiences the following symptoms:

• intense burning pain in the area where the skin is broken (decreases within a few hours);
• at the site of the bite, the color of the skin does not change, the skin becomes swollen, and bloody fluid is released from the wounds;
• when a limb is affected, its paralysis develops, which spreads upward, involving the muscles of the trunk and face;
• impaired movement of the eyeballs;
• swallowing disorder;
• hiccups;
• difficulty breathing;
• drooping eyelids and lower jaw;
• salivation;
• speech disorder;
• involuntary urination and defecation;
• rapid development of signs of intoxication: severe weakness, nausea, vomiting;
• severe anxiety;
• disturbance of consciousness;
• weakening of cardiac activity.

Death can occur 2-7 hours after the bite.

Symptoms of rattlesnake and pit snake bites

The venom of pit snakes and rattlesnakes contains:

• hemocoagulants, hemorrhagins and hemolysins - cause the destruction of red blood cells, promote vascular thrombosis and increase their permeability, subsequently their action leads to a decrease in blood clotting and the development of disseminated intravascular coagulation;
• cytotoxins - lead to damage to the kidneys, heart, liver and cause tissue necrosis in the bite area.

After being bitten by pit snakes (copperheads and copperheads) and rattlesnakes, teeth marks and scratches appear on the skin.

The victim experiences severe pain and a strong burning sensation at the site of the bite.

The temperature of the skin at the site of the bite increases.

Swelling at the site of the bite appears after 30-60 minutes and quickly progresses, spreading to the surrounding tissues, and after 6-8 hours, bullae (bubbles) with serous and bloody contents and multiple bruises appear on the skin, which merge and can form necrotic wounds.

In most cases, tissue necrosis develops from rattlesnake bites. And the peak manifestation of the poison’s effect is observed during the first 2-4 days.

The victim develops intoxication and hectic fever:

• the temperature rises to high numbers;
• chills appear;
• sweating;
• intoxication develops;
• nausea and vomiting appears;
• there is a risk of developing spontaneous bleeding from the stomach or intestines;
• a decrease in blood pressure and the development of shock are possible;
• the appearance of a rubbery, metallic or minty taste in the mouth (from rattlesnake bites).

When poisoned by rattlesnake venoms, victims experience changes in blood clotting: an increase in INR, a decrease in the number of platelets, and hypofibrinemia.

Blood coagulation disorders can lead to the development of DIC-like syndrome, manifested by hemorrhages on the skin, spontaneous bleeding, and the appearance of blood in the stool and urine.

Poisoning from diamondback rattlesnake and Mojave rattlesnake venoms may result in serious neurological impairment and signs of difficulty breathing.

When poisoned by the venoms of most North American snakes, victims exhibit signs of neuromuscular conduction disorders:

• muscle weakness;
• muscle twitching;
• paresthesia.

In some cases, victims experience a change in mental status.

Symptoms of coral adder bites

Coral adders are common in South and North America. The bites of these snakes pose a real threat to life, and about 7-8 people die from poisoning every year.

Without timely assistance, a person may die 20-24 hours after the bite from respiratory arrest and cardiac dysfunction caused by the action of neurotoxins and hemolysin.

With these snake bites, in most cases the pain and swelling of the skin is minimal, transient or completely absent, and such symptoms are often mistaken for a dry bite. This fact can be misleading for both the victim and doctors.

After a few hours, the victim begins to feel weak in the bitten limb, and after 12 hours, neuromuscular disorders begin to appear. These include the following symptoms:

• muscle weakness;
• enlarged axillary lymph nodes;
• cold sweat;
• headache;
• fear of light;
• pain and itching in the ears;
• sensations of roaring and crackling in the ears against the background of sudden night deafness;
• clicking in the ears when swallowing;
• black earwax;
• coldness of the lower extremities;
• rash on feet; sensations of coldness in the bones;
• stitching pain under nails;
• drowsiness;
• changes in consciousness;
• decreased visual acuity;
• fear of rain;
• euphoria or depression and fear;
• fear of loneliness;
• muscle flaccidity;
• cranial nerve palsy: ptosis, swallowing problems, drooling, drooping upper eyelids, blurred vision, double vision, speech, swallowing and breathing problems;
• stomach ache;
• pain when swallowing and a feeling of constriction in the throat;
• signs of sore throat;
• bad breath;
• nasal congestion;
• nosebleeds with sensations of pain in the nasal cavity;
• purulent and foul-smelling nasal discharge and the formation of yellow-green crusts (ozena) in the nasal cavity;
• diarrhea from cold water or debilitating diarrhea in weakened patients;
• the appearance of ulcers and erosions in the intestines and stomach
• rash on lips;
• fainting when trying to bend the body forward.

Such manifestations of poisoning by coral snake venom continue for 3-6 days. In the absence of timely medical care and artificial ventilation, the victim may die from respiratory failure and respiratory arrest.

What should you not do if you are bitten by a snake?

— Apply a tourniquet. Application of a tourniquet contributes to a sharp disruption of blood circulation in the limb and contributes to more severe tissue damage.

- Cauterize the bite site.

- Drink alcohol.

— Make incisions in places of swelling or bite to drain “poisoned blood.”

- Inject the bite site with adrenaline or local anesthetics.

- Be exposed to physical activity.

- Apply heat.

—Ice the affected leg or arm for a long time. The cold effect on the bite area should be local.

First aid tactics for a snake bite

Timely provision of first aid for a snake bite largely determines the future prognosis.

First aid for a snake bite is as follows:

Lay the victim in a horizontal position and calm him down. Once the snake is attached to the skin, it is removed immediately. If possible, the snake is identified or killed for further examination by a specialist.

Call an ambulance (if possible).

If the snake cannot be identified, the victim is observed. The absence of pain, burning and swelling in the bite area may indicate that the snake is non-venomous.

Remove clothing and jewelry from the affected area, which can impair circulation and worsen swelling.

If it is known for sure that the bitten snake is poisonous, then first aid measures begin immediately.

Urgent Care

Immobilize the affected limb (immobilize) using an improvised bandage or splint.

Suction of the venom should be carried out in the first 5-10 minutes after the bite is applied, since at a later date it is no longer so effective.

Timely implementation of this emergency measure helps remove about 50% of the poison from the body.

If possible, it is better to use suction or a rubber bulb for this procedure, and if they are not available, suction is performed with the mouth. To perform suction, you should grab the skin at the puncture site in a fold and lightly knead it (this will allow the puncture sites to open up better from the teeth). Use your teeth to grasp the areas of skin surrounding the wounds and suck out the poison while pressing on the skin. Saliva containing poison should be spat out immediately. The same actions should be performed for 20 minutes.

Disinfect the wound with hydrogen peroxide, chlorhexidine, a weak solution of potassium permanganate or brilliant green. It is better not to use alcohol or alcohol solutions to treat a wound.

Apply a loose bandage made of clean cloth or bandage to the wound and a moderately compressive bandage over the entire limb (the finger should freely penetrate under the surface of the bandage and not cause discomfort to the victim).

Apply cold to the bite site. When using ice, it should be removed every 5-7 minutes (to prevent tissue frostbite).

To reduce the symptoms of intoxication, the victim should drink as much as possible (up to 3-5 liters of drinking or alkaline mineral water per day), take vitamin K and C. Alkalinization of water can be done by preparing a soda solution: 1-2 teaspoons of soda per 1 liter water.

If possible, a dropper with a 5% glucose solution (400 ml) should be placed. To reduce blood pressure, you can use an intravenous infusion of 400 ml of Reopoliglucin.

Give the patient to take antihistamines (Diphenhydramine, Loratadine, Tavegil, Levocetirizine) or administer intramuscularly (1 ml of 1% solution of Diphenhydramine, Pipolfen or Suprastin).

Give the patient to take glucorticoid drugs (Dexamethasone - 2-4 mg/day, Prednisolone - 5 mg/day) or administer them intramuscularly (Prednisolone - 30-60 mg, Dexamethasone - 80 mg).

After a cobra bite, the victim may have trouble breathing. To stabilize it, you should bring a cotton swab moistened with ammonia to the patient’s nose.

If there are signs of respiratory and heart failure, the patient is administered Cordiamin, Ephedrine and Caffeine.

When breathing and cardiac activity stop, artificial respiration and indirect cardiac massage are performed.

Antidotes

In case of poisoning with snake venom, the administration of antidotes - antisnake serums - is indicated. Their administration is most effective in the first hours or days after the bite. Subsequently, if necessary, the administration of serums can be repeated.

Treatment for poisoning by snake venoms

Treatment of snake venom poisoning should be comprehensive and include symptomatic, detoxification and specific therapy. If necessary, resuscitation measures and artificial ventilation are carried out.

Treatment tactics are determined by the complexity of the clinical case and consist of the following measures:

To reduce the allergic reaction, the patient is advised to take desensitizing drugs and corticosteroid hormones. The duration of their use and dosage depend on the severity of the patient’s condition.

Detoxification therapy consists of infusion of solutions of sodium chloride, Refortan, glucose, Ringer, fresh frozen plasma and forced diuresis using diuretics (Trifas, Furosemide).

To eliminate the neurotoxic effects of the poison, anticholinesterase drugs are used - Proserin, Galantamine.

To prevent secondary infection and purulent complications, broad-spectrum antibiotics are used (Ceftim, Levofloxacin, Cefataxime, etc.).

To prevent hepatic-renal failure, the patient is prescribed Eufillin and hepatoprotectors (Hepadif, Essentiale, Berlition, etc.).

In case of severe poisoning (especially children), hemodialysis and hemosorption are indicated.

During treatment, monitoring of basic vital parameters and indicators of a general blood count, its biochemical parameters and a general urine test is always carried out.

Preventing snake bites

There are no specific ways to prevent poisonous snake bites.

To prevent snake bites, the following rules of conduct should be observed:

— When you see a snake, you should not perform actions that provoke the snake to attack: scream, tease, or make sudden movements.

— When entering a potential risk area, be sure to wear boots or high boots and clothing made of thick fabric.

- If you are walking through tall grass, then use a stick with which you can make sure that there is no snake.

— When walking in snake habitats, watch your step.

— When in places that are remote from cities and medical institutions, carry medications with antidotes.

— When staying outdoors for a long time in tents or sleeping bags, carefully choose a suitable place to sleep. It should be located on a hill with low vegetation, away from mountains and rocks.

— Be sure to check tents and sleeping bags for snakes every time you need to use them.

Source

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What to do if bitten by a viper?

The viper avoids humans and attacks only if it senses danger: for example, if you step on it or touch it with your hand while working in the garden. If you are bitten by a viper, you need to try not to panic and calm down, recommends Pyotr Davydov, deputy chief physician for the medical department of the A.S. Emergency Medical Care Station. Puchkova.

“Fatal cases from a viper bite are extremely rare and are usually caused by an anaphylactic reaction caused by an allergen contained in the venom,” explains the doctor.

Therefore, a viper bite is very dangerous for children and people suffering from allergies.

If a snake attacks, you should immediately take any antihistamine in the usual dosage and drink as much water as possible to ease the allergic reaction. If the bite is on an arm or leg, you need to treat the wound with an antiseptic, apply a clean bandage to it, and immobilize the limb. You can apply a splint to slow down the lymphatic drainage at the site of the bite and the spread of the poison, and then urgently go to the doctor: there the patient will be given an antidote.

A person feels a burning pain at the site of a snake bite, swelling, and the skin acquires a red-blue tint. Nausea, vomiting, and dizziness may occur.

You cannot treat the wound with a hot iron (despite the savagery and uselessness of the method, it is quite common “among the people”), or tie the limb with a tourniquet.

“Applying a tourniquet will lead to even greater damage to tissues in which the blood supply is already deteriorated due to the poison,” says Pyotr Davydov. - Subsequently, this can lead to necrosis. Moreover, the tourniquet does not stop the absorption of the poison. But applying cold to the bite site is advisable. Cold reduces excessive vasodilation."

It is strictly forbidden to drink alcohol when bitten by a snake - it dilates blood vessels, accelerates the absorption of the poison and increases the load on the body; drinking alcohol can lead to a more pronounced vascular reaction and even collapse.

Most doctors also do not recommend sucking out viper venom, despite recognizing the effectiveness of this method in the first seconds after a bite.

“Due to the fact that a viper’s bite, unlike, for example, a cobra’s bite, most often does not pose a mortal danger, we do not recommend sucking out the viper’s venom from the wound of an adult, so as not to cause an infection, which can then have a very unfavorable course,” explains Petr Davydov . “However, this method, applied in the first seconds after a snake bite, before lymphatic drainage has time to work, is really very effective and allows you to remove up to 50 percent of the poison and thereby reduce the allergic reaction. But it is important to do this immediately after the bite, since then the poison is absorbed into the deeper layers of the skin and it is difficult to remove it from there.”

If a snake has bitten a pet - a cat or dog - it must be urgently taken to a veterinarian, where it will be injected with anti-viper serum, just like a person.

More details: https://tass.ru/obschestvo/11035221