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    When to Seek Medical Care

    Any snakebite victim should go to a hospital emergency department unless the snake is positively identified by an expert as nonvenomous. Remember, misidentification of the snake species could be a fatal error.

    Bites by nonvenomous species require good wound care. Victims should receive a tetanus booster if they have not had one within the last 5 years.

    Exams and Tests

    Diagnosis of snakebite is made based on the history of the event. Identification or description of the snake would be helpful, because not all snakes are venomous, and because different kinds of antivenom exist for different species of snakes. In Australia, the doctor may use a kit to determine the specific type of snake. The doctor also looks for evidence of fang marks or local trauma in the area of the bite. Pain and swelling accompany many snakebites.

    • The doctor treats breathing problems, shock, and/or immediately life-threatening injuries even before a full workup is complete.

    • The wound needs to be examined and cleaned.

    • The doctor will likely send blood and urine samples to the laboratory to look for evidence of bleeding, problems in the blood clotting system, kidney problems, or muscle death. These problems may not be initially apparent, but can have dire consequences if missed.

    • The victim is monitored to look for worsening symptoms at the wound site, or worsening systemic symptoms in the breathing or cardiovascular systems.

    • A rare complication in very swollen limbs is compartment syndrome. Limbs are divided into compartments of muscles, blood vessels, and nerves. Severe swelling can cut off the blood circulation to a compartment. When the circulation is cut off, the victim usually has severe pain and numbness. Later, the limb may get white and cold. If not treated in time, the limb may need to be amputated.

    Snakebite Treatment -- Self-Care at Home

    Common sense will guide your efforts if you are bitten by a snake or are witness to someone else being bitten. Even a bite from a nonvenomous snake requires excellent wound care. The victim needs a tetanus booster if he or she has not had one within 5 years. Wash the wound with large amounts of soap and water. Inspect the wound for broken teeth or dirt.

    Take the following measures:

    • Prevent a second bite or a second victim. Snakes can continue to bite and inject venom with successive bites until they run out of venom.

    • Identify or be able to describe the snake, but only if it can be done without significant risk for a second bite or a second victim.

    • Safely and rapidly transport the victim to an emergency medical facility unless the snake has positively been identified by an expert as harmless (nonvenomous). Remember, misidentification could be fatal. A bite without initial symptoms can still be dangerous or even fatal.

    • Provide emergency medical care within the limits of your training.

      • Remove constricting items on the victim, such as rings or other jewelry, which could cut off blood flow if the bite area swells.

      • If you are in a remote area in which transport to an emergency medical facility will be prolonged, you should apply a splint to the affected limb. If you do apply a splint, remember to make sure the wound does not swell enough to make your splint a tourniquet, cutting off the blood flow. Check to make sure toes and fingers are still pink and warm, that the limb is not going numb, and that pain is not getting worse.

      • If you have been bitten by a dangerous elapid and have no major local wound effects, you may apply a pressure immobilizer. This technique is mainly used for Australian elapids or sea snakes. Wrap a bandage at the bite site and up the extremity with a pressure at which you would wrap a sprained ankle. Then immobilize the extremity with a splint, with the same precautions concerning limiting blood flow. This technique may help prevent life-threatening systemic effects of venom, but may also worsen local damage at the wound site if significant symptoms are present there.

      • While applying mechanical suction (such as with a Sawyer Extractor) has been recommended by many authorities in the past, it is highly unlikely that it will remove any significant amount of venom, and it is possible that suction could actually increase local tissue damage.

    • The two guiding principles for care often conflict during evacuation from remote areas.
      • First, the victim should get to an emergency care facility as quickly as possible, because antivenom (medicine to counteract the poisonous effects of the snake's venom) could be life-saving.

      • Second, the affected limb should be used as little as possible to delay absorption of the venom.

    • A number of old first aid techniques have fallen out of favor. Medical research supports the following warnings:

      • Do NOT cut and suck. Cutting into the bite site can damage underlying organs, increase the risk of infection, and does not result in venom removal.

      • Do NOT use ice. Ice does not deactivate the venom and can cause frostbite.
      • Do NOT use electric shocks. The shocks are not effective and could cause burns or electrical problems to the heart.

      • Do NOT use alcohol. Alcohol may deaden the pain, but it also makes the local blood vessels bigger, which can increase venom absorption.

      • Do NOT use tourniquets or constriction bands. These have not been proven effective, may cause increased tissue damage, and could cost the victim a limb.
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