Sunday, June 20, 2010

Snake-bite management >> India

Snake-bite is one of the more serious health issues, especially in India where deaths due to snake-bites (I am referring to venomous snake-bites) are estimated well over 50,000 every year. Even though actual envenomation takes place less often, it is best to stay prepared for an emergency. This is not only for people residing in remote rural areas (who are the majority victims) but also for urban city residents. There has been a transformation of habitat for snakes from forest systems >> farmlands >> villages >> towns >> cities, but owing to their extraordinaire adaptive nature, they have managed to survive everywhere. No doubt there are only a few common species that are found in and around human habitation, unfortunately the list includes the BIG 4!

Spectacled Cobra Naja naja (Elapidae)

Common Krait Bungarus caeruleus (Elapidae)

Russell's Viper Daboia russelii (Viperidae)

Saw-scaled Viper Echis carinatus (Viperidae)

These four species make up the BIG 4 medicinally important snakes of India. They are lethally venomous and occur commonly throughout most of India. Of course there are other species that too demand utmost respect like other cobras Naja spp., kraits Bungarus spp., coral snakes Calliophis spp. and Sinomicrurus sp., King Cobra Ophiophagus hannah, sea snakes (Hydrophiidae) and some pit vipers (Viperidae). Bites are however rare from these mostly because of their distribution and biological pattern.

Most of the snake-bites take place unknowingly when the snake is accidentally threatened; while in other cases, well some people just ask for it!

Whatever be the reason, it is not unlikely that you might end up in a situation where a simple strategy and presence of mind can prove to be a limb-saver, in some cases, a life-saver.

The snake-bite management strategy is presented below; and presence of mind, well, I just hope you have it!

Suck out venom
Make incision to bleed out venom
Go to traditional healers or anything similar
Try out home remedies
Apply tourniquets
Apply ice
Clean out the bitten part
Try and catch/kill the snake

All of the above activities either do not work or are extremely dangerous to perform. In fact, they will do more harm than good.

Following is what you can and should do:
+ Make sure the victim and others are at a safe distance away from the snake
+ Try to memorize the snake’s appearance (from a safe distance!)
+ Remove watches / rings / other jewelry from the bitten part
+ Keep the victim calm and reassured
+ Do not panic
+ Try to immobilize the bitten limb; do not make the victim run and avoid making him/her walk if possible
+ In case of neurotoxic bites (All elapids and hydrophiids: Cobras, King cobras, kraits, coral snakes and sea snakes), pressure immobilization (Sutherland method) with long crepe or other stretchy bandage (5 - 10 cm wide, several rolls) and splint to be applied immediately to the bitten limb, starting at the digits and working up to the groin or arm pit.
+ Do not waste any time and arrange for a quick transport to the nearest hospital treating snakebite cases, as safely and comfortably as possible
+ If possible, note the time of bite and progression of symptoms
+ Describe the snake and the whole incident to the attending doctor

*Anti Snake Venom Serum is the only cure*

If your neighborhood has a high density of snakes, it is advisable to prepare a snake-bite protocol (plan of action in case of an emergency) best suited to you. This can simply be important contact people and numbers who should be informed first, name / address of nearest hospital treating snake-bites, best mode of transport and related details, name / contact no. of doctor, etc. Make sure all family members understand their role in an emergency.

As always, prevention is better than cure
+ Do not walk around with bare feet outside your house.
+ Take great care when clearing vegetation, raking dry leaves in your garden.
+ Supervise kids in the outdoors, especially in a green neighborhood.
+ Use torch/flashlight at night and keep wearing those shoes. Check shoes before wearing them.
+ Watch your step and see before you sit!
+ Keep your backyard free of junk and make sure your solid waste is managed properly.
+ If you see a snake, do nothing. Let it go. Do not try to pick it up or kill it.
+ If a snake has entered your premises, call professional snake rescuers.

Snake-bite is painful, expensive and extremely risky. Please do not get bit.

Stay safe!


Unknown said...

This is invaluable information and must be made widely available. The myths that you have written about abound everywhere and perhaps every district or taluk hospital must have a multilingual signboard about this in the emergency area. That effort will perhaps save both snakes and humans.
Thank you for this post, Soham.

Unknown said...

Hello Soham Bhaiya,u've written it very nicely....short but very informative and interesting too...Thanks a lot for the info....

Dhruvajyoti Basu said...

Nice blog, good work, keep it going!

rishit shroff said...

nice work soham,
short, concise & to the point!!

Ranjan RJ said...

Good and valuable information indeed. let us pass it to others too...

Vikram Jit Singh, The Times of india, Chandigarh said...

A complex situation conveyed with crystal clarity that makes it accessible to a wider audience.

Amila Kanchana said...

We have the big 4 over here too,plus another big 1 or 2. The bite victims are generally well managed by our government health sector. There used to be an advanced indigenous system too, but I don't know how good that practice now is . The sad part is that a lot of non venomous snakes get killed by people.