On 8/16/2024 at 4:49 PM, GreasyFingers said:

How would hospital staff know how to identify the snake species, unless they were specifically trained to identify snakes.

In other counties (Red Cross) the recommendation is do not take the snake to the hospital. As the earlies poster said they will use an anti venom depending on the symptoms.

Anti-venom is a secondary priority for snake bites, having a ventilator available is first. Get to the nearest hospital and let them do their jobs.

On 8/15/2024 at 7:22 PM, Nick Carter icp said:

 

   There are no poisonous snakes in Thailand 

GeographicReference

Actually there is a poisonous snake. The red neck keelback. It is both poisonous and venomous!

12 hours ago, cjinchiangrai said:

Anti-venom is a secondary priority for snake bites, having a ventilator available is first. Get to the nearest hospital and let them do their jobs.

I am sorry - but you are incorrect.

Snake venom has different components , and they are present in different amounts in different species of snakes.

This is a simplified explanation.

Venom can contain cytotoxins - which damage tissue.

It can contain neurotoxins - which damage nerve tissue.

It can contain haemotoxins - which affect the circulation, by affecting blood clotting or blood cells.

Knowing the species of snakes that has bitten you helps greatly, as targeted antivenom can be administered which can reduce the damage done to your body.

A ventilator may aid in the treatment of a snakebite from a snake with highly neurotoxic venom, as respiratory paralysis may occur - but this is supportive therapy, rather than targeted treatment for the envenomation.

5 hours ago, PythonHouse said:

Actually there is a poisonous snake. The red neck keelback. It is both poisonous and venomous!

Garter Snake is also poisonous, because of it's diet. From AI ...

... "These specific garter snakes eat highly toxic newts (like the rough-skinned newt) that contain tetrodotoxin (TTX). Instead of being harmed, the snakes sequester (absorb and retain) the newt's poison in their livers. This makes the snake's body temporarily poisonous to predators, such as birds or foxes.

• Venomous vs. Poisonous: The mild venom the snake produces is in its saliva and is meant to kill prey, which is harmless to humans. The poison acquired from newts is stored in the liver and flesh, making the snake toxic to anything that tries to eat it.

• Not all garter snakes: This diet-based toxicity applies primarily to western garter snake populations. Common garter snakes in other regions primarily eat earthworms, slugs, and frogs, and do not carry this level of toxicity" ...

In other snake news ...

Our resident Golden Tree Snake making an appearance today, Gotten a wee bit bigger, and could expain the eggs missing from the bird nest.

Moved its head, to let me know it was right next to my hand, as I adjusted the security light, that was pointing downward.

Pay attention you idiot, and good thing it wasn't a more venomous and aggressive snake. Like the one the wife killed the other day, that got caught snoozing at the house.

Edited July 15Jul 15 by KhunLA

15 minutes ago, G Rex said:

I am sorry - but you are incorrect.

Snake venom has different components , and they are present in different amounts in different species of snakes.

This is a simplified explanation.

Venom can contain cytotoxins - which damage tissue.

It can contain neurotoxins - which damage nerve tissue.

It can contain haemotoxins - which affect the circulation, by affecting blood clotting or blood cells.

Knowing the species of snakes that has bitten you helps greatly, as targeted antivenom can be administered which can reduce the damage done to your body.

A ventilator may aid in the treatment of a snakebite from a snake with highly neurotoxic venom, as respiratory paralysis may occur - but this is supportive therapy, rather than targeted treatment for the envenomation.

Getting to a ventilator is the top priority. They do not waste anti-venom on people that are not breathing.

4 minutes ago, cjinchiangrai said:

Getting to a ventilator is the top priority. They do not waste anti-venom on people that are not breathing.

If not really close to hospital, have a piece of sturdy hose available, in case you notice throat swelling and breathing is hard.

@ 12:10 of this vid ... explains the need for tube. Good vid to watch all of, if never seen before. Folks in Samui ... pay attention.

Edited July 15Jul 15 by KhunLA

11 minutes ago, cjinchiangrai said:

Getting to a ventilator is the top priority. They do not waste anti-venom on people that are not breathing.

Wow! So you are suggesting that you prioritise respiratory assistance.

Meanwhile , we will just let the venom continue to attack and destroy the body.

Great plan! lol

If the patient has been envenomated, and requires a ventilator - he/she/(them/they/it) will already have multiple issues with other organ systems - issues that would have been prevented or reduced after administration of the appropriate antivenom.

This is why specific targeted is the priority.

A ventilator is an aid to therapy - but is not the priority.

Edited July 15Jul 15 by G Rex

25 minutes ago, G Rex said:

A ventilator is an aid to therapy - but is not the priority.

It is if you can't breathe ... as was the priority in the vid I posted, if watched.

Like our home but live in arguably the wettest area in Thailand with huge lakes and rivers, as well as huge boulders. Snakes love it and many people die in the area from bites. Last year alone a few died within couple kilometers from our home from Cobra bites. People were out warning the local hunters and gatherers of the deaths.

The hills were crawling with mushroom gatherers yesterday. Very dangerous but they have fun, mostly the over 50 growd and the young don't participate. and make money at the same time. A two meter Cobra zoomed across the patio last week. Impossible to ever get a photo because they move incredibly fast. Been bitten by a snake on a jungle trail and didn't even see it but felt it immediately. Too far from the hospital and took hours to get back to a car. I didn't even see the snake and other than an infection and a little pain, it wasn't an issue. The dog got sprayed by a cobra last month and that wasn't fun for him. Rushed him to a vet and got some shots and all was good in 24 hours.

37 minutes ago, G Rex said:

Wow! So you are suggesting that you prioritise respiratory assistance.

Meanwhile , we will just let the venom continue to attack and destroy the body.

Great plan! lol

If the patient has been envenomated, and requires a ventilator - he/she/(them/they/it) will already have multiple issues with other organ systems - issues that would have been prevented or reduced after administration of the appropriate antivenom.

This is why specific targeted is the priority.

A ventilator is an aid to therapy - but is not the priority.

In any critical medical situation, heartbeat and respiration are the top priorities. Guess why. Elapids will stop your breathing way before the anti-venom gets there. Organ damage is more of a viper problem, but they still address that after the heartbeat and breathing check. All you need to know about snakebites in Thailand is get to the hospital now. They have a plan, they know more about it than we do.

Just now, cjinchiangrai said:

They have a plan, they know more about it than we do.

Agreed.

I digress - how many snake bite cases have you actually seen, or treated? All successful outcomes?

As a veterinarian, I have treated many hundreds of patients with snake envenomation - and yes elapids are bad. In Australia, our black, brown & tiger snakes were the biggest problem in my area. Intravenous fluid therapy, medical treatment to prevent shock or anaphylaxis and antivenom administration was the foundation of our treatment regime. Oxygenation via intubation and/or ventilation with a respirator was infrequently used, unless advanced neurological affects were present.

I am not trying to nit-pick - but telling people that a ventilator is more important than treatment including antivenom is just wrong.

1 minute ago, G Rex said:

Agreed.

I digress - how many snake bite cases have you actually seen, or treated? All successful outcomes?

As a veterinarian, I have treated many hundreds of patients with snake envenomation - and yes elapids are bad. In Australia, our black, brown & tiger snakes were the biggest problem in my area. Intravenous fluid therapy, medical treatment to prevent shock or anaphylaxis and antivenom administration was the foundation of our treatment regime. Oxygenation via intubation and/or ventilation with a respirator was infrequently used, unless advanced neurological affects were present.

I am not trying to nit-pick - but telling people that a ventilator is more important than treatment including antivenom is just wrong.

The point is to get to the hospital, vet or otherwise, where ventilators exist and are available. They may, or may not use them, but if you are not there, it may not matter. I have had similar discussions on this where people were talking about how to find anti-venom yourself. Every hospital in Thailand has a treatment potocol, and if anti-venom is the choice, they will arrange it. Do not try to out think the system, you are wasting time that you may not have.

6 minutes ago, cjinchiangrai said:

The point is to get to the hospital, vet or otherwise, where ventilators exist and are available. They may, or may not use them, but if you are not there, it may not matter. I have had similar discussions on this where people were talking about how to find anti-venom yourself. Every hospital in Thailand has a treatment potocol, and if anti-venom is the choice, they will arrange it. Do not try to out think the system, you are wasting time that you may not have.

And in Thailand, go to the Govt Hosp, as they more likely have the anti venom vs private hospitals. Being expensive with short shelf life, private won't usually have, as not profitiable for them.

Centalized distribution prioritises govt hospitals.

7 hours ago, PythonHouse said:

Actually there is a poisonous snake. The red neck keelback. It is both poisonous and venomous!

True, that's the snake that watches Nascar when it's not out hunting for prey, after a six pack or two.

43 minutes ago, G Rex said:

Agreed.

I digress - how many snake bite cases have you actually seen, or treated? All successful outcomes?

As a veterinarian, I have treated many hundreds of patients with snake envenomation - and yes elapids are bad. In Australia, our black, brown & tiger snakes were the biggest problem in my area. Intravenous fluid therapy, medical treatment to prevent shock or anaphylaxis and antivenom administration was the foundation of our treatment regime. Oxygenation via intubation and/or ventilation with a respirator was infrequently used, unless advanced neurological affects were present.

I am not trying to nit-pick - but telling people that a ventilator is more important than treatment including antivenom is just wrong.

Antivenin is one thing that keeps a person or animal alive while the body fights it also, along with possible transfusions and respiratory support if a Cobra or Krait bites, as you know. One other reason we're leaving Thailand is the amount of venomous snakes here compared to back in Texas, and how many are deadly against children.Also how fast some can kill before you get to a hospital. Average of 8 or more deaths a year along with thousands of bites here.

Edited July 15Jul 15 by fredwiggy

1 hour ago, cjinchiangrai said:

The point is to get to the hospital, vet or otherwise, where ventilators exist and are available. They may, or may not use them, but if you are not there, it may not matter. I have had similar discussions on this where people were talking about how to find anti-venom yourself. Every hospital in Thailand has a treatment potocol, and if anti-venom is the choice, they will arrange it. Do not try to out think the system, you are wasting time that you may not have..

okay - the tune is changing a bit?

I wholeheartedly agree that a snake bitten person should go to a hospital - and no, a lay person cannot self administer antivenom, nor can they give themself intravenous fluid therapy etc.

Not all hospitals have ventilators (especially in rural areas, (where more bites occur)), and even if they do - they may not have the personnel experienced in operating such equipment available at all times.

So - do not try to out think the system - if bitten by a potentially lethal snake, get to the closest hospital - any hospital. After being medically assessed there - and having your condition stabilised -they will decide the appropriate course of action. If they don't have the required equipment, they can arrange transporting the patient to somewhere that does have it.

2 hours ago, cjinchiangrai said:

Guess why. Elapids will stop your breathing way before the anti-venom gets there. Organ damage is more of a viper problem, but they still address that after the heartbeat and breathing check.

I just re-read this comment. Quite the expert aren't you? Albeit a touch patronising.

I will bow to your superior knowledge, and choose to no longer play this game.

What’s the title and author of your snake book?

Is it The Snakes of Thailand from Chulalongkorn University Press by Cox, Hoover, Chanhome, Thirakhupt, 2012?

If so, I have a digital copy I’d be happy to pass along. It’s a really large file so expect a file server where content only stays up for three days. I'll need an email address.

Merel J. Cox is the snake guy in Thailand. All the other books on Thai snakes are very incomplete.

Incidentally, I have been bitten by a green Malaysian pit viper on the big toe (on Silom road!). Leg swollen double and some pain to touch.

We regularly get green vipers in our house. They just go and hide. Wife is expert at trapping them and calling the snake patrol.

Snakes don't have much chance by me. I would prefer to let them go on their way, but the dogs and birds don't like them. It's amazing to see the birds spot one and do the snake call and the dogs take care of the rest. The dogs were strays that adopted us, mother and daughter, so not sure but I think the young one lost an eye to a spitting cobra and really hates them. The mother was bitten by a cobra in the neck and survived. probably because the snake was almost dead. Lost track of how many, luckely most are just rat snakes.

On 8/15/2024 at 11:20 PM, cjinchiangrai said:

No need to kill or bring the snake. The antivenom covers several varieties. Just get to the hospital and let them handle it.

Correct, don't try to catch or kill the snake as there is a very good chance you will be bitten again. Take a photo of the snake? Look it up in a book? Really? So much wrong information in the OP.

Learn the basics of snake bite first aid to slow the spread of venom through the body and get to a hospital asap.

Where I live if you are bitten by an eastern brown snake or a taipan every minute counts. Without first aid your looking at a survival time of around twenty minutes. With the correct application of a compression bandage and a splint immobilise the limb this can be extended to many hours. The venom of the Australian snakes moves through the lymphatic system, hence limb immobilisation is crucial.

People still die from the bites of the two snakes mentioned.

I should add that the size of these two snakes doesn't really matter and in fact a juvenile snake can be much more dangerous as it has less control over the amount of venom injected.

Edited July 22Jul 22 by emptypockets

First priority is to get to a hospital. Do not waste time. Most people cannot identify different snakes or know the correct first aid, so trying different procedures is usually not a good idea. Stay calm, keep movement to a minimum, avoid panic, and let the medical staff assess the bite and decide if antivenom is needed.

Doctors do not need the snake itself to start treatment. If someone has a suspected venomous snakebite, treatment is based on:

The symptoms and signs.

The appearance of the bite.

Knowledge of which venomous snakes live in the area.

Sometimes blood tests that show the effects of venom, such as clotting problems or muscle damage.

In some countries, hospitals may use specialized venom detection tests, but these are not routinely available in many places. Doctors do not test the venom before giving antivenom in most cases. If the patient has clear signs of serious envenomation, antivenom is often given without identifying the exact snake.