There are over half a dozen kinds of venomous snakes that
are native to the island of Bali (see previous edition of
Bali Advertiser). All snakes (except perhaps for the Common
Trouser Snake) will attempt to avoid biting humans, but many
will do so in defense if deliberately provoked or accidentally
disturbed. The most obvious way to treat a potential snake
bite then, is to avoid being bitten in the first place.
Most snakes will give an aggressor a chance to retreat. Some
will hiss or spit or “stand up” in a characteristic
defensive posture. The cobra will open its “hood”
and will stand in an “S” position in order to
warn off intruders. Some species give little or no warning
before biting, such as the pit viper that can move from a
defense posture to a full bite attack without warning sometimes
with little provocation. Other species will become limp and
“play dead” to avoid an encounter.
The message here is quite clear. Leave snakes alone where
possible and never try to taunt, catch or kill a snake. Should
you have the misfortune to have been bitten by one of these
creatures there are several first aid treatments that you
can implement until medical attention is available. Remember
that:
While snakes will not always “envenomate” (inject
poison) when they bite, it must be assumed that they did.
(Some snake venom will cause little immediate effect, but
may cause life threatening reactions minutes or hours after
the bite).
While not all snakes have a venomous bite, it must be assumed
that the snake is venomous unless the species of the snake
is known (for example pet snakes that have benign bites such
as the ever popular python).
Never waste time on snake identification or looking for first
aid equipment. Get to a medical facility as soon as possible.
The principal of first aid for snake bite is firstly to avoid
distribution of the venom, and secondly to reduce chance of
infection at the puncture site. Gone are the days of John
Wayne’s “slice, suck and spit” treatments!
Here are some common sense first aid tips to remember should
you or yours ever have a nasty encounter:
1. Allow bite to bleed freely for 15-30 secs.
2. Cleanse and rapidly disinfect area with Betadine (assuming
you’re not allergic to iodine).
3. If the bite is on the hand, finger, foot or toe, wrap leg/arm
rapidly with 3" to 6" crepe bandage past the knee
or elbow joint immobilizing it (you can improvise by using
a sarong, scarf, towel or other piece of wide fabric). Leave
the area of fang marks open. Wrap the bandage no tighter than
you would for a sprain. Make sure pulses in the ankle or wrist
are present.
4. Apply hard direct pressure over bite using a gauze pad
or clean piece of fabric. Soak gauze pad in Betadine solution
if available. Strap gauze pad tightly in place with adhesive
tape.
5. Immobilize bitten extremity, use splinting if available.
6. Try to stay calm and do not cause the victim to panic.
Panic states will raise the victim’s heart rate causing
faster distribution of the venom.
7. If possible, try and keep bitten extremity at heart level
or in a gravity-neutral position. Raising it above heart level
can cause venom to travel into the body. Holding it down,
below heart level can increase swelling.
8. Go to nearest hospital or medical facility as soon as possible.
9. Try and identify, offending snake. Visual identification/description
usually suffices.
10. Bites to face, torso or buttocks are more of a problem.
Apply pressure with a betadine soaked pad to the bite and
seek medical attention immediately.
11. If the victim has been injected with a “neurotoxin”
(nerve poison) that is characteristic of the cobra or Malayan
krait, it may be necessary to assist the victims breathing
by performing mouth to mouth resuscitation until such time
as the victim can be given assistance at a medical facility.
* Note: If you do not have Betadine or gauze pads do not waste
time looking for them. The most important message here is
to get to a medical facility A.S.A.P.
What Not to Do if Bitten by a Venomous Snake
1. DO NOT permit removal of pressure dressings, or bandage
until you are at a facility ready and able to administer anti-venom.
As soon as the dressings are released the venom will spread
causing the usual expected problems of venomous snakebite.
The hospital at this time must be prepared to administer the
antidote (anti-venom).
2. Do not eat or drink anything unless okayed by medical sources.
3. Do not engage in strenuous physical activity.
4. Do not apply oral (mouth) suction to bite.
5. Do not cut into or incise bite marks with a blade.
6. Do not drink any alcohol or use any medication.
7. Do not apply either hot or cold packs.
8. Do not apply a narrow, constrictive tourniquet such as
a belt, necktie or cord.
9. Do not waste time or take any risks trying to kill, bag
or bring in offending snake.
*Remember wide pressure bandaging must not be wrapped so tight
as to cut off systemic venous or arterial circulation. Properly
applied such bandages will NOT compromise the systemic circulation.
Remember that this general first aid advice for any snake
envenomation; it does not take the place a complete medical
assessment or treatment and observation at a medical facility.
Until next edition stay healthy, stay happy and watch your
step!
Kim Patra is a qualified Registered Nurse / Midwife, and
mother of three, who has been living and working in Bali for
past 15 years. She has assisted many traveller (... and others)
either as a flying medical escort or just a voice on the end
of the phone! Kim is happy to discuss any health concerns
that your may have. Her e-mail contact is info@chcbali.com
