Basic First Aid :
• Immediately seek medical assistance especially if the area changes color, begins to swell or is painful
• Don’t try to capture the snake. Try to remember its length, eyes, color and shape. If it’s safe you can try to take a photo with a camera or phone as it may aid snake identification
• Keep the person calm and still to stop further spreading of venom. Remind the victim that most snake bites are not fatal
• If the bite is on the limbs, immediately remove any rings, bracelets, shoes or watches. In case swelling occurs loosen any tight clothing to avoid cutting off blood supply that may lead to gangrene, which can be fatal or result in amputation of the limb. Splint or use a sling on the bitten limb to restrict movement
• Have the person lie down, if possible, so that the bite is at or below the level of his heart. Raising it can cause venom to travel through the body quicker; Having it hanging, can increase swelling.
• Clean the wound and cover it with a clean, dry dressing
• Don’t use a tourniquet or apply ice because it may cause tissue ischemia and gangrene respectively
• Do not give aspirin, ibuprofen or other pain relievers to the victim
• Avoid the many harmful and time-wasting traditional first-aid treatments such as local incision or excision of puncture sites, suction by mouth, administration of potassium permanganate as they are potentially harmful and none has any proven benefit.
• In suspected neurotoxic cobra or mamba bite, especially if the patient is far from medical help apply a broad pressure crepe bandage or clothe over the bite, starting from below the bite. Immobilize the bitten limb with a sling but the tightness should allow for some blood flow.
Notice to Doctor :
• Assess for signs of poisoning: difficulty swallowing or breathing, muscle weakness or paralysis, or bleeding disorders.
Administer anti-tetanus inj if none has been given in the last 5years.
• Administer polyvalent antivenom and other anti-inflammatory agents if necessary.
• The bandages should be left in position until appropriate antivenom and resuscitation equipment has been assembled.
• Avoid crepe or other bandaging in all cytotoxic bites.
• Assess regularly (q 10-15 min) for the development of complications in patients suspected of neurotoxic snake bites.
• Start CPR if the patient is unresponsive and no respiratory movement is detectable.
• Administer intravenous fluids (preferably normal saline) to shocked, hypotensive patients. Vasopressor agents, such as dopamine ,noradrenaline or phenylephrine may need be administered if there is inadequate response.
• Control pain with paracetamol or or paracetamol/codeine combinations (monitor for respiratory depression)