Diagnosis & Treatment — First aid / lay people
- collapse, loss of consciousness.
- Calm the patient.
- Place the patient in a stable lateral position, or possibly the Trendelenburg position (shock position).
Anxiety (fear of death) plays an important role following accidents with venomous animals and has an additional negative influence on the clinical course after an accident.
Loss of consciousness after an accident with a venomous animal can have many causes. It is important to place the patient in a stable lateral position to avoid aspiration. If peripheral circulatory failure is present, the shock position may improve the patient's condition. If resuscitation is necessary, it is only in exceptional cases that lay people will be sufficiently well trained to be able to intervene.
How can absorption and circulation of the venom be delayed?
- Compression-immobilisation method or comparable methods and splinting of the bitten extremity.
- Avoid pressure points when applying the splint (padding).
- Transport the patient.
To date only minimal or no local effects, in particular no local swelling, have been observed following Hydrophiidae bites. Thus if a compression-immobilisation bandage is correctly applied, no additional local damage is to be expected.
Average time between the bite and death
Hydrophiidae whose venom causes primarily muscular effects and no neurological effects: Enhydrina schistosa: hours (to days). 4 patients died on average 24.5 h (13–52 h) after E. schistosa bites (Reid 1961a).
Hydrophiidae whose venom causes neurological and muscular effects: probably Astrotia stokesii (other Hydrophiidae?): minutes (to hours?).
This information makes it possible to assess the probability of reaching medical facilities in time and points out the importance of using the compression-immobilisation method or a comparable method.
The "unnoticed" sea snake bite
Attentiveness to symptoms occurring within approx. 2 hours of circumstances in which a Hydrophiidae bite could have taken place (wading in shallow water; less likely but still possible, swimming, fishing, in particular fishing with nets in shallow water).
The bite may occur in such a way that the victim does not notice or misinterprets it, e.g. the victim thinks to have trodden on a sharp object, e.g. a fragment of shell, while wading. Even if the affected area of skin is inspected, the bite may still not be noticed. The venom fangs can leave behind small circular marks, but often only a superficial scratch mark. The site of the bite itself is painless and does not show any redness or swelling. Thus there is a risk that the first thing that is noticed are the symptoms caused by the systemic action of the venom. Even then, children and tourists unfamiliar with the area would not consider a sea snake bite to be the possible cause.