What are the first aid precautions to be taken in case of a snake bite?

Question

I'll be trekking through a dense monsoon forest which has a sizable population of king cobras and vipers. I'll be at least 5 hours away by walk to the nearest human settlement and another 1-2 hours by vehicle to the nearest medical center.

In such a case, what are the first aid steps that I need to take in case I get bitten by a snake? I have heard about tying a rope tightly just above the bite to prevent the venom from spreading, although I don't know the complete validity of the same. Are there other things that can help me to arrest the fatal effects of the venom before I get some medical attention?

Answer 1

There is hardly anything very effective first aid as such, considering the fact that you are 5 hrs walk from any medical facility.

I guess I can assume that you will be roaming in rain forests of Agumbe or anywhere in Southern Western Ghats since you referred to King Cobras.

If in India, you would definitely like to take a look at The Big Four. Considering the region where you refer, There are two types of venomous snakes you should know about:

1. Neurotoxic: Indian Spectacled Cobra, King Cobra. (You won't find Monocled or Caspian Cobras in that region), Kraits.
2. Haemotoxic : All Vipers. (Bamboo Pit Viper aka Green Pit Viper, Saw Scaled Viper, Malabar Pit Viper, Russell's Viper). Malabar Pit Vipers are very rare in Indian Subcontinent, so it is unlikely that you will come across one.

I doubt if there are any Chemotoxic snakes in india. There can't be because I have enlisted every possible Fatally Venomous snake in India that I know about.

Firstly: Usually venomous snakes tend to preserve their venom (except for Juveniles). So, once it bites, it retreats. But still try and ensure that the snake is at a safer distance and get away from it in order to avoid another bite.

Secondly, To make the anti-venom work efficiently on you, you should try and gather some visual information about the snake that bit you. Don't try to capture the snake or kill it and bring it with you, but try to capture a picture of the snake from your cellphone/camera (if available), or somehow try and remember it's color and shape so that it can be described, which will help in choosing the right anti-venom.

1. (Specific to India) - The big 4 in India are Cobras, Saw-scaled Vipers, Russell's Vipers, Kraits. They don't really give you much time to get to the hospital. But this doesn't mean that one should hurry. Keep calm, panic will make the adrenaline come in picture and the blood circulation will increase, only resulting in causing the venom to spread much quicker. If you are going to be carried (on a stretcher), then lie flat, avoiding the movements.

2. Allow the bitten part of the body to be lower than the Heart level.

3. Do not let anyone try to suck the venom out of the bite site. (I have heard cases of such a horrid thing done, and the one who sucked also got to be treated as the venom in victim's blood entered the sucker's blood through minute injuries in his gum/teeth).

4. Wrap a large constricting band between the bite site and the Heart, so that the blood mixed with venom reaching to heart is controlled. Wrap is snugly, Do not wrap it very tight or else the venom will damage the entire limb. Usually in such a case, the limb has to be amputated. No one would want to loose the limb if the snake has not injected the amount of venom enough to be fatal. (Have ever heard of a Dry-Bite?? Vipers do that often!)

5. (Specific to Neurotoxic snakes) - If it is a cobra or a king cobra, try and be awake and communicate with the people who are carrying you.

6. Try not to make cuts around bite site as it swells. It will swell, no matter what.

7. Do not apply any kind of disinfectant or tourniquet.

8. Remove any rings or tightly constricting items because the affected area will swell.

9. Do NOT take anything by mouth such as caffeine or alcohol or any painkillers at all. As different wiki's say,

   Caffeine is a central nervous system and metabolic stimulant. Stimulants may produce a variety of different kinds of effects by enhancing the activity of the central and peripheral nervous systems. Since Caffeine is a Bronchodilator, which is a substance that dilates the bronchi and bronchioles, decreasing resistance in the respiratory airway and increasing airflow to the lungs.

If we can relate elevated heart rate due to panicked state of mind and/or adrenaline, and the consequent elevated respiration rate, we should prefer to avoid consuming caffeine which is a Bronchodilator and a Stimulant.

10. (Specific to India) - Kraits are nocturnal species. Usually these are spotted during late hours of day and night. If you are asleep (as you normally will), it is hard to realize that you are bitten by a Krait since the bite feels like an ant or a mosquito bite and the actual bite is not significantly visible. The symptoms of such a bite are: The facial muscles get tight in one to two hours, may be unable to talk or see due to it's Neurotoxic venom.

Edit: References:

1. Caffeine

Answer 2

I am not familiar with the reptiles around the world. I can however, share the results of my (informal) research (read: googling) of several years ago. I did that, because I was going alone in the summer forest several hours from help at any time.

I discovered a viper incident report, among the many forum statements that snakes in Bulgaria are not deadly. So here is a summary.

A guy was picking strawberries in Rila Mountain, when a viper bit him on the hand. He squeezed some blood out of the wound and drunk water from the nearby spring. He later reported that the icy water made him feel better. His several companions helped him down to their nearby cars. There he received various medications and was wrapped in blankets. He was feeling well, but his eyes had already too slewed for him to open them.

He was transported to a hospital where, after several days he was able to open his eyes, and after several more was able to leave. As far as I remember, the only treatment they gave him were general infusions.

Unfortunately the text is in Bulgarian, plus I haven't been able to locate it for a couple of years.

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Based on this, my conclusions were:

• if possible, purchase venom extractor (they are cheap).
• a poisoned person cannot walk significant distances (above 20-30 min).
• loss of vision is the most significant danger.

Therefore, I constructed a plan of how to act in case of a snakebite and replayed it in my mind for many days, until I could tell the steps without hesitating - drunk, sleepy, tired, thirsty - regardless.

It was something like this:

1. Try to squeeze the blood out of the wound. (1 minute)
2. Do NOT make a tourniquet if you are alone and are unsure of taking it out later. If within a group WedaPashi's advice would be better. (0 minutes)
3. Take the tent out of the backpack and pitch it (5-10 minutes).
4. Enter the tent, take out clothes, water and food out of the backpack. (1 minute)
5. Put on all the clothes, pitch the bedroll, place the water and food close to your face. (5 minutes)
6. Lay over a sleeping bag (if it is daytime, it would be hot), do not panic, try to dial someone from a mobile phone, don't expect to succeed.