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Poisonous animals
Cnidarians (Jellyfish, Corals and Anemones)
Venomous fish
Hymenopterans (Bees, Wasps and Ants)
Sea snakes
Terrestrial snakes
Miscellaneous animals
North America
Mexico and Central America
South America and the West Indies
North Africa, Near and Middle East
Central and Southern Africa
The Far East
Indian Subcontinent and Southeast Asia
Australia and the Pacific Islands

Diagnosis & Treatment — First aid / lay people


General problems

  • Fear,
  • collapse, loss of consciousness.
F  First Aid
  • Calm the patient.
  • Place the patient in a stable lateral position, or possibly the Trendelenburg position (shock position).
C  Comments

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?

F  First Aid

Elapids (Cobras, Kraits):

Viperids, crotalids, colubrids (Rhabdophis sp.):

  • Immobilisation of the bitten extremity using a splint (piece of wood or something similar).
  • Avoid pressure points when applying the splint (padding). Transport the patient.
C  Comments

The risks of the compression-immobilisation method limit its use to elapid bites (Cobras, Kraits). Following Cobra bites, local swelling begins on average 2–3 h after the bite (Reid 1964), but following Krait bites there is no local swelling at all. The compression-immobilisation method is justified with elapid bites, as the neurotoxic effects of the venom begin rapidly, and there is a risk of respiratory failure occurring before medical facilities can be reached.

Exposure of the eyes or mucous membranes to venom (spitting cobras)

F  First Aid

Eye irrigation/thorough washing of the mucous membranes with water.

Average time between the bite and death

  • Ophiophagus hannah: 1.5–10 h (Sawai et al. 1992).
  • Bungarus caeruleus: on average 18 h (3–63 h) (Warrell 1990b).
  • Daboia russelli: on average 3 days (15 min–264 h) (Warrell 1990b).
  • Deinagkistrodon acutus: 15–49 h (Sawai et al. 1992).
  • Gloydius blomhoffii: 3–9 days after the bite (Sawai and Lah 1978, Sawai 1989).
  • Protobothrops flavoviridis: within 24 h (Sawai 1989).
C  Comments

This information makes it possible to assess the probability of reaching medical facilities in time and, barring other circumstances, justifies the use of a tourniquet for elapid bites (see above).