सर्पले टोकेको खण्डमा के गर्ने? सर्पदंस प्राथमिक उपचार ?

Snakebite management in Nepal : Sarpale tokeko khandama ke garne?

snake bite treatment

Table of Contents(toc)

Introduction: Snakebite first aid in nepali. What to do if a snake bites?

Snake bite is a common cause of hospital and emergeny visit as well as hospital admission worldwide. It is stimated to kill 20000- 90000 people annually worldwide. The venomous snakes include Viperids (rattle, gaboon viper) and elapids (cobra, taipans). The snakes of family Colubridae are mostly nonvenomous while some are venomous. Even with a bite of poisonous snake as more as 30% of them can be dry bite without envenomation. 

Snake with fangs open in grass
Poisonous snake

How do snakes produce venom and how does snake venom work?

The venom is produced in paired glands that lie below the eyes. The snakes have hollow fangs through which the venom is delivered when biting. 

The snakes venom is mixture of various substances protein and nonprotein which together act as antgen and enzymes to cause all the symptoms related to snake bite. 

Flowchart containing classification of snakes
Classification of snakes

What are the symptoms of snakebite?

The symptoms of nonpoisonous snakebite are most of the times limited to local effects which later may progress to systemc if not treated well. But symptoms of poisonous snakebite may progress rapidly and may cause unconsciousness within hours then death. The symptoms include:
  • Typical bite mark is seen: (see picture)
  • Pain in the bite mark area associated with redness and swelling
  • Bleeding
  • Blistering around the bite mark
  • Disturbed vision
  • Feeling of weakness
  • Nausea
  • Vomiting
  • Diarrhea
  • Difficulty breathing and may lead to respiratory arrest soon
  • Increased or decreased pulse rate or heart rate
  • Decreased blood pressure
  • Diminished consciousnesss and thinking ability
  • Bad taste in mouth like metallic or nonedible things like taste
  • Increased secretions like salivations, sweating, tearing, watery stool, urination
  • Decreased sensations, numbness and tingling
  • Muscle twitching, lost control, involuntary motions
  • Seizure
  • Bleeding from mucosa, mouth, nails, and bruises
  • Hematoma formation, ecchymoses 

  • Tyeps of bite venomous vs nonvenomous snake bite
    types of bite: Venomous and nonvenomous

What to do if I see a anakebite or  I get bitten by a snake?

If there is snake get to a safer area away from reach of the snake. and then do the following:
  1. Ask for help: Call an emergency service near you, call someone around you for healp. Emergency service in Nepal includes number 100 for police and 102 for Nepal ambulance service. 
    1. If you're in safe place and can see the snake take a picture of it if possible. This helps identification of snake and tell if its poisonous or not as well as to choose the Anti-snake venom.
    2. Lay down in a nuetral position in plane surface. Do not try to walk or run if its not necessary. 
    3. Remove the rings or tight clothings if possible before swelling or blisters start.
    4. If soap and water is available wash teh bite wound with it.
    5. Cover the skin with clothing. Note down the time of bite if possible. 
    6. Keep calm and wait for the help to arrive. Most of the snakebites are nonpoisonous. 

    What  should you never do in case of snakebite?

    1. Try to pick the snake or try to kill it or trap it.
    2. Do not wait to get help. Do it immidiately and tell your exact loaction asap.
    3. Do not apply torniquet of any sort.
    4. Do not cut, bite, suck or slash the cut part.
    5. Do not apply ice, heat on bite.
    6. Do not immerse in water, hot or cold, any other liquid. Do not apply any other thing like soil or herbal medicine.
    7. Do not drink alcohol or any other drugs right away.
    8. Do not take painkillers (NSAIDs) , they may increase chance of bleeding and hence death.
    9. Do not self so anything except mentoned above.

    Below this section contains technical content: Proceed to read if you want to:

    What are the types of poisonous snakes?

    • Viperidae: Russel's viper, Gaboon Viper
    • Crotalidae: Rattle snake, pit viper, copperheads
    • Elapidae: Cobras, Kraits, Mambas
    • Hydrophidae: Sea snakes
    • Atractaspididae: Mole vipers or false vipers

    Difference between poisonous and nonpoisonous snakebites:

    Table: difference between poisonous vs nonpoisonous snake bites
    Poisonous and nonpoisonous snake difference

    What are different types of snake venoms?

    1. Neurotoxin: Elapidae
    2. Hematotoxic: Viperidae
    3. Myotoxic: Hydrophidae

    How to apply splint and bandage for pressure immobilization for snake bites?

    snake bite first aid: bandage appication and splinting technique for lower limb bite by a poisonous snake
    Splinting technique and bandage application for snakebite site

    • Use a splint which can be made of various materials shown in picture
    • Use a broad clothe preferably pressure bandage or crepe bandage
    • Start application from distal to bite site and run through bite proximally
    • Immobilize the affected area with splint in he end.
    • For hands arm pouch sling can be used for immobilization
    • Keep the bandage snuggly fi rot just compressing but should not have vascular occlusion
    • Remember: Do not apply arterial torniquet. This has more harm than bebefit
    • Immobilization and bandage + splinting prevents spread of the venom systemically preventing or at least delaying systemic poisoning.
    Anti-snake venom and other bites and stings will be discussed separately. The links will he kept here. Or use our search tool for the topic of your interest. 
    Thank you. 
    References: Uptodate and other high quality medical resources and textbooks. 

    If you're reading about snake bite piercings go here.

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