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Poisonous animals
 
Cnidarians (Jellyfish, Corals and Anemones)
 
Venomous fish
 
Scorpions
 
Spiders
 
Hymenopterans (Bees, Wasps and Ants)
 
Sea snakes
 
Terrestrial snakes
 
Miscellaneous animals
 
North America
 
Mexico and Central America
 
South America and the West Indies
 
Europe
 
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):

  • Compression-immobilisation method or comparable methods and splinting of the bitten extremity.
  • Avoid pressure points when applying the splint (padding).
  • Transport the patient.

Viperids, crotalids, colubrids:

  • 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 or comparable methods limit their use to elapid bites (Cobra, Kraits). Following Cobra bites, local swelling begins after an average delay of 2–3 h (Reid 1964), but following Krait bites there is no local swelling at all. The compression-immobilisation method or comparable methods are 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 

F  First Aid

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

Average time between the bite and death

  • Asiatic Cobras: on average 8 h (12 min–120 h).
  • Bungarus caeruleus: on average 18 h (3–63 h).
  • Daboia russelii: on average 3 days (15 min–264 h).
  • Echis sp.: on average 5 days (25 h–41 days). These data are from E. ocellatus bites (Nigeria)!

(Warrell 1990b).

C  Comments

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