Clinical Management

The onset of symptoms may take a while, and may only be detected by either a blood or urine test. If any of the following symptoms present, (see below) take appropriate action to manage the condition of the victim.

Systemic reaction to tiger snakebite.

Less than an hour after snakebite: 

• Headache 

• Vomiting 

• Transient hypotension (low blood pressure), associated with confusion or unconsciousness 

• Diplopia (double vision).

Keep airways clear and monitor breathing. Monitor for shock. In the event, raise patient’s legs and lower head if the skin is clammy and pallor, these symptoms are a possible indicator of hypotension (shock).

1 to 3 hours after the bite:

• Paralysis of cranial nerves, e.g. ptosis, (eyelid dysfunction) dysphagia, (difficulty swallowing) dysphasia (speech impairment) diplopia (double vision).

• Abdominal pain, increasing confusion.

• Hemoglobinuria (reddish urine, caused by the presence of blood cells).

• Haemorrhage (bleeding from snakebite wound).

• Hypertension (high blood pressure) and tachycardia (rapid heart beat).

Apply CPR if necessary.

More than 3 hours after bite:

• Paralysis of large muscles of limbs.

• Progressive loss of respiratory muscle function.

• Peripheral circulatory failure, hypoxia (blood oxygen deficiency), and cyanosis (bluish appearance mainly around the lips).

• Myolysis (muscle destruction leading to protein release into the circulatory system).

• Myoglobinuria, (dark urine) evidenced by the effects of toxins found in Tasmanian snake venom, degrading muscle cells and releasing protein (rhabdomyolysis) which, after passing through the kidneys may cause tubular necrosis leading to potentially fatal acute renal failure. Urine may appear black due to myoglobin (an iron- and oxygen-binding protein found in the muscle tissue) being present.

Monitor conscious status, apply CPR if breathing ceases and seek immediate emergency assistance.

Always carry at least two 10 –12cm elasticised sports bandages whenever in areas where snakes are likely to be found. 

(Referenced from ‘Australian Animal Toxins’ by Straun Sutherland) For more information:

go to http://reptilerescueaustralia.blogspot.com/

First Aid and Clinical Management of Snakebite.

Snakebite may or may not present with a local reaction. Depending on the severity of the bite and volume of venom, a snakebite victim may not feel local pain. 

Generally most bites are fleeting and may not be effective, these occurrences are called dry bites, where a snake doesn’t inject venom; however where a snake bites and holds, venom usually will be injected and pain at the bite site experienced.

Observation of the bite site may show steady bleeding from the effects of anti-clotting activity found in snake venom. At this point it is critical that first aid be applied as a matter of urgency.

The most common route for envenoming is via the lymphatic system, a fine network of vessels that transport a clear fluid called lymph. Containing T-cells, lymph is the body’s frontline defence mechanism where antigen, a substance or molecule that, when introduced into the body, triggers the production of an antibody by the immune system, which will then kill or neutralize the antigen that is recognized as a foreign and potentially harmful invader, usually derived from a cut or similar injury, including venom. 

Lymph is not pumped around the body by the heart, but rather by muscle movement, that is why immobilisation is important when applying first aid for snakebite.

Less likely is an intravenous bite directly to a blood vessel; however these can occur and are considered far more serious than lymphatic infusion.

Whenever conducting any outdoor activity such as hiking, fishing, wood cutting etc, a pair of 10 –12cm elasticised broad bandages should bean essential addition to your kit. In the event of a sprain they will prove effective; however where snakebite occurs they may save your life.

Important: Any suspected bite must be treated as positive until determined otherwise. First aid must be applied fast and effectively and medical assistance sought as a matter of urgency.

In the case of a bite to the limb, apply a pressure bandage, starting at the extremities and working up the limb until either the elbow or knee is reached, then work back down until all the bandage is used. The second bandage is started at the armpit or groin working down and overlapping the first bandage by one bandage width.

The bandage should be as firm as if applied for a sprain (about 55mm Hg). Cover the entire limb with the tips of toes or fingers exposed. The patient should be either sitting or preferably laying down, and where appropriate a splint applied especially when children are bitten to ensure the limb is immobile.

Monitor the patient and remain vigilant should their condition deteriorate, and treat for shock when or if necessary. If a patient loses consciousness, roll the victim into the recovery position and ensure the airways are clear, if breathing ceases, apply CPR until medical personnel can assume responsibility. 

Where possible, notify the nearest emergency facility or hospital as to the nature of the emergency, and condition of the patient. This will allow emergency staff to be ready to respond upon arrival at the medical centre. 

If you are able, stay on the line so that medical advice can be given should the bite recipient’s condition worsen.

Do not give fluids or food, and definitely no alcohol; small occasional sips of water only.

Warning! Do not wash the wound and do not attempt to catch or kill the snake. Monovalent tiger snake anti-venom gives cross protection for all Tasmanian snakes.

Example of bandaged limb.

TIGER SNAKE & AUST VENOMOUS SNAKE INFORMATION

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