Snake Bite Treatment
Worldwide, it is estimated there are a minimum of 1 to 2 million annual snakebite “incidents”. This number includes bites by non-venomous species. Of that number, roughly 50,000 to 100,000 bites result in fatalities worldwide. Many of the world’s most venomous snakes have venoms that are very straightforward and ‘easy’ to treat effectively with the proper anti-venom. However, there are some snake bites that cause a clinical explosion of problems for which anti-venoms are not very useful.
Snake venom is a complex set of enzymes that can dissolve both muscle and red blood cells. It should come as no surprise that this is exactly what happens when they bite a human.
The following is a list of the most dangerous and deadly snakes in the world. This list takes into account the potency of the snake’s venom, the number of fatalities, and the aggressiveness of the snake. These bites must be treated aggressively, so it is essential to get to help quickly. Pressure dressings and tourniquets are appropriate. Antivenom should be administered as soon as possible, so immediate evacuation is essential. It is important to know where these deadly snakes are found and to be aware of appropriate treatments and where hospitals are located as a traveler goes to these various countries.
Black Mamba
The black mamba is found throughout most countries in Sub-Saharan Africa and is incredibly fast, traveling at speeds of up to 12 miles per hour. The Black Mamba is aggressive and territorial, characteristics not usually attributed to snakes. This snake is an olive-green color. The inside of its mouth that is black. Its poison is a very fast acting neurotoxin.
Russell Viper
This snake is found in Asia, throughout the Indian subcontinent, most of Southeast Asia, southern China, and Taiwan. It is responsible for more human fatalities than any other venomous snake. It is a member of the big four venomous snakes in India, which together are responsible for nearly all Indian snakebite fatalities.
Egyptian Cobra
This is the most common cobra in Africa and is responsible for many deaths there. It typically makes its home in dry to moist savanna and semi-desert regions, with at least some water and vegetation.
Mozambique spitting cobra
This is a type of cobra, native to Africa. It is considered one of the most dangerous snakes in Africa, second only to the Mamba. It can spit its venom.
Australian brown snake
This is a deadly Australian snake. One 1/14,000 of an ounce of this venom is enough to kill a person. It is the world’s second most venomous land snake. Brown Snakes are very fast-moving and highly aggressive. When agitated, they will hold their necks high, appearing in a somewhat upright Sshape. The snake will occasionally chase an aggressor and strike at it repeatedly.
Death Adder
This snake is native to Australia. It is one of the most venomous land snakes in Australia and the world.
Pit Vipers
In North America, pit vipers are found in 47 of the 48 contiguous states except for Maine. The pit viper includes multiple species of rattlesnake, copperhead and the cottonmouth (water moccasin). Pit vipers have specific recognizable anatomy including a triangle-shaped head, catlike, elliptical pupils, and heat-sensing pits between eyes and nose. Venom is dispersed from ducts in the fangs. About 25% of pit viper bites are “dry” or without injection of venom. Pit viper venom dissolves tissue, blood and nerve tissues. Therefore, they are very painful bites.
Each snake has a varying potency of its venom based on multiple factors:
Age of the snake
Location of bite
Size, age, and health of victim
Depth of the bite
Amount of venom injected
Emotional state of snake
Time of year that the bite occurs
These are painful bites with patients reporting severe burning at the bite site within minutes. Soft tissue will swell outward from the bite, and blood oozing from the bite is common. Bruising occurs as blood cells ‘dissolve’ and patients will feel weak. It is common to have various tastes occur in the mouth. Tingling will happen in the mouth, face, and extremities as fasciculations occurs while nerve tissues are destroyed. The treatment of viper bites is simple. Evacuate all victims of bites from venomous snakes. Follow typical rules of treatment to support the airway, breathing, and circulation while transporting. Remove any tight-fitting jewelry and clothing to avoid a tourniquet effect. CroFab® has been shown to be effective and safe.
Coral snake
Coral snakes in North America have a very distinct color banding pattern. The bite of the coral snake typically involves a finger, toe, or fold of skin, because the coral snake is unable to open its jaws wide. These are not painful bites. There is minimal or no local swelling. It may be difficult to see the bite(s). Fang marks may be difficult to identify. Symptoms will often progress rapidly once they appear. These are nausea and vomiting, headache, abdominal pain, diaphoresis and pallor, paresthesias, and numbness.
The treatment of a Coral snake bite is evacuation for definitive care. It is a venomous snake bite and needs to be treated urgently. Pressure immobilization has been studied on animal models and is used in Australia for elapid snakebites but is not indicated for coral snake bites in the United States. Antivenom administration should be planned for all victims of elapid bites, as symptoms initially may be minimal but progress rapidly.
Snake bite treatment has been plagued over the years with poor suggestions and very bad information that has been adopted as fact. Here a list of things to avoid because they are either harmful to the victim or do not work:
The Sawyer Extractor™ has been touted to remove venom if applied within two to three minutes of the bite. However, there is no evidence to support this at all. Therefore, the Extractor is NOT recommended.
In North America, do NOT use pressure immobilization. Simple immobilization is fine, but it has no proven benefit.
Electric shock therapy should NOT be used in any snakebite and can be harmful.
Local application of ice is contraindicated, as it may worsen necrosis.
Do NOT attempt to try to catch or kill the offending snake. Therapeutic recommendations for North American snake envenomation are the same for all species and attempts to capture a snake may result in additional envenomation and potentially another victim. Even a dead snake’s jaw can clamp down and envenomate a human.
Do NOT use aspirin, as it may worsen bleeding.
Do NOT cut and suck on the wound, as this maneuver may infect the wound with oral bacteria and is ineffective at removing venom.
Do NOT use a tight-fitting tourniquet that restricts arterial or venous flow.
