If bitten by a snake

[AyG]

A couple of recent rather-too-close encounters with snakes whilst walking the dogs recently has made me think about what I should do if bitten (by a snake that is, not the dogs).

I think I've read in the past that anti-venins are only stocked by government hospitals. Is that correct? And if so, should I head for the nearest government hospital? Or would it be OK to head to the much closer private hospital and expect them to get the appropriate anti-venin from the government hospital? This is in Bangkok, FWIW.

[Sheryl]

Yes, yes and no unless you know for a fact thst the private hospital stocks antivenom.

The other important thing is to if possible catch the snake and bring it or picture of it with you as the antivenoms are snake specific

[Aforek]

An Australian specialist of Taipan told in a video not to inject anitvenom if the snake didn't inject some venom it self : it would be more dangerous that the venom

but for Taipan, venom or not, not time to go to hospital ! Snakes not inject venom systematically

OP, which snakes did you encounter ?

[lopburi3]

Vipers, kraits, python and cobra are what I have been close up and personal with - and if bitten I would be to hospital immediately (even if by a non venom python). Snakebite is not a wait and see situation in Thailand.

[h90]

The question is if bitten should you fight with the snake to bring it along and risk to get a second time bitten or not?

[AyG]

OP, which snakes did you encounter ?

I have no idea. I have an idea in my head that the big, fat ones are constrictors, so not particularly venomous. The recent encounters were with thin ones which obviously hadn't read the textbook that says that snakes are afraid of human beings and will try to flee given the chance. Both were about a metre long, and one had a body triangular in cross section (which I'm told by a Thai friend is a sure sign it's venomous).

To be honest, it's quite difficult to take a detailed description of a snake whilst trying to keep two less-than-perfectly-trained-and-definitely-curious dogs away from it lest they be bitten.

[Sheryl]

Russell viper has a sort of triangular marking and is venomous...google a pic.

When snskes bite and inject venom they are typically lethargic afterwards and don't go far so can usually be found near the scene of the crime. A picture will suffice if no suitable long handled weapon nearby.

I treated a lot of snakebites when I worked in refugee camps on the border. The patients almost always suceeded in bringing the snake in with them (dead of course). I accumulated quite a large collection of snakes in jars of formaldehyde in my office.

At a minimum try to get a good look, it's important.

[Aforek]

The recent encounters were with thin ones which obviously hadn't read the textbook that says that snakes are afraid of human beings and will try to flee given the chance. Both were about a metre long, and one had a body triangular in cross section (which I'm told by a Thai friend is a sure sign it's venomous).

May be a viper ( Russel viper is very venomous and agressive , but is not found every where in Thailand , I have never seen some living , only one dead ) ; vipers are not afraid of human beings

as the story of snakes which flee, it's not a general rule : doing my jogging, in 4 years I have seen many snakes : 3 of them ( 1 young python and two cobras, at a distance of one meter from me ) just wait to see ( they have very good eyes ) who was making such vibrations in the ground ; they saw it was me , and left, but not flee, not agressive

the others snakes fled, especially cobras, which , in my experience, are not agressive : they prefer not to confront human being

Python are not venimous, but they bite

[lopburi3]

Actually during two years in Takhli I had to avoid russel viper about 30% of the time when entering a building at night (where the viper would be on cement step under a security light) - that is the number of times I actually noticed - expect most times he fled on my approach. Russel viper is very common here - although in Bangkok all snakes are not nearly as common as in the past.

As for cobras had very large ones look me in the eye (at my eye level) along roadside as I walked by on several occasions - they had no intention of leaving - but in fairness they did not attack (I was only about 4 feet away from one before seeing on a dark night). As said snakes are not normally aggressive and will move if you give them a way out.

Would highly advise having leash on dog when walking and carry a big stick.

[Sheryl]

The biggest danger is at night especially if walkinh through grass or foliage. Not only is there less visibility but snakes are more actively about. Most bites occur because the person accidentally stepped on a snake or almost so, anf the snake is defending itself. They will not take the initiative to approach and bite.

When walking at night in rural areas fields etc a good idea is to have a stick with you and thump the ground ahead of you to warn any snakes you are coming. They respond to vibration and will get enough out of the way not to be stepped on.

[RasiMike]

If you are hit apply a compression bandage and immobilise the limb (if the injection site is on a limb) and get to hospital.BTW. Some venomous snakes DON'T inject venom in every case so trying to catch/kill it may just get you in more trouble- up to you.

[chubby]

what would be the protocol, if one had no idea what type of snake bite one got, and went to the closest hospital? do they have a wide spectrum anti-venom?

[Sheryl]

There is no such thing. All antivenoms are snake specific and also carry some risks so giving multiple different antivenoms is not safe/advisable.

If someone is brought in with snake bite and no info at all on the snake the only recource is to wait and observe. Snake venoms fall into 2 main groups: neurotoxins (cobra, krait) and hematological toxins (vipers). These can be differentiated by clinical signs though only after the effects begin. That narrows it down somewhat but still leaves more than one possibility. At that point if the medical personnel happen to know that a specific snake of the indicated group is prevalent in the location where the bite occurred they might go ahead and treat accordingly....and it might or might not work. If the toxin was of the neuro type the patient will already have stopped breathing and be on life support as this plays out. Some providers might not treat with antivenom when snake unknown but rather just treat supportively until the venom wears off. Some might go ahead and try more than one antivenom in same situations. Risky either way.

They will also try to get friends or family go out and get the snake or pic of it.

[chubby]

I know a bunch of hash house harriers, with 1000s of runs around Bangkok, and no one to my knowledge has ever been bitten, much seen snakes, they say "all the locals have killed them off", or they say because there are 30 people going along the same path, the snakes will have moved off, if there are any. And that the largest risk seems to be 'doing recce' by yourself, I guess, esp. since there'd be no assistance, if one was bitten, and away from civilization.

<br>

but, I'm thinking of buying some snake gaiters, as heavy and unused as they seem to be. Occasionally there are also outstations, or we do the CM 'jungle' type runs, which is more rural, etc.

<br>

any more thoughts ?

[Sheryl]

A group of people running will easily clear the immediate area of snakes. They will feel the vibrations on the ground.

The main danger is walking through foliage/underbrush. Especially, though not only, at night. Use a large stick to beat the ground in front of you so any snakes know you are coming.

[MaeJoMTB]

As for cobras had very large ones look me in the eye (at my eye level) along roadside as I walked by on several occasions - they had no intention of leaving - but in fairness they did not attack (I was only about 4 feet away from one before seeing on a dark night). As said snakes are not normally aggressive and will move if you give them a way out.

Vipers stand their ground, almost always. That's why they are so dangerous.

They sit on the trails, and if you step on them, they bite.

[lopburi3]

AFAIK only the King Cobra is known for standing there ground (at at there size they can do so) - the vipers that liked the heat in our cement at night would slowly wonder off - but I have been more impressed with huge pythons - "I stop for snakes" takes on a whole new meaning when you see something in front of you 30 feet long and imagine them warping around car and crushing it and you.

[Sheryl]

Never known a

[EcigAmateur]

On 6/1/2015 at 9:52 AM, Sheryl said:

There is no such thing. All antivenoms are snake specific and also carry some risks so giving multiple different antivenoms is not safe/advisable.

If someone is brought in with snake bite and no info at all on the snake the only recource is to wait and observe. Snake venoms fall into 2 main groups: neurotoxins (cobra, krait) and hematological toxins (vipers). These can be differentiated by clinical signs though only after the effects begin. That narrows it down somewhat but still leaves more than one possibility. At that point if the medical personnel happen to know that a specific snake of the indicated group is prevalent in the location where the bite occurred they might go ahead and treat accordingly....and it might or might not work. If the toxin was of the neuro type the patient will already have stopped breathing and be on life support as this plays out. Some providers might not treat with antivenom when snake unknown but rather just treat supportively until the venom wears off. Some might go ahead and try more than one antivenom in same situations. Risky either way.

They will also try to get friends or family go out and get the snake or pic of it.

 

I see polyvalent antivenom for many different snakes ?!?

https://www.thaivisa.com/forum/topic/793192-snake-antivenom-dog-bitten-by-snake-what-can-the-vet-do-if-we-do-not-know-which-snake/

 

 

 

[Sheryl]

The polyvalent is in 2 different types so it is still necessary to have some idea of snake type i.e. neurotoxic vs hemarraghic toxin. In the absence of any information as to appearance of the snake that is known only after the patient starts to exhibit symptoms and waiting for that is, to say the least, nerve-wracking risky. Not to be done if it can possibly be avoided, should always try to get the snake or pix of the snake. They often don't go far once they've bitten.

 

I'm not sure how many hospitals now stock the 2 polyvalent antiserums.

 

 

 

 

[EcigAmateur]

On 11/29/2017 at 3:24 PM, Sheryl said:

The polyvalent is in 2 different types so it is still necessary to have some idea of snake type i.e. neurotoxic vs hemarraghic toxin. In the absence of any information as to appearance of the snake that is known only after the patient starts to exhibit symptoms and waiting for that is, to say the least, nerve-wracking risky. Not to be done if it can possibly be avoided, should always try to get the snake or pix of the snake. They often don't go far once they've bitten.

 

I'm not sure how many hospitals now stock the 2 polyvalent antiserums.

 

 

 

 

 

Yes, I find incredible that there is no online official list of antivenin availability at Thailand hospitals !

How many people die every year because of this ?

 

 

 

[thedemon]

About 10 years ago I was bitten on the ankle by a pit viper at my house in Bangkok. My housemaid at the time was able to identify the snake (in Thai). I think it was a Pope's Pit Viper.

 

I was treated in the emergency room at Bumrungrad Hospital. The doctors told me that they had anti-venom available but that they do not routinely administer that unless the patient has an adverse reaction to the venom because the anti-venom itself carries risk of a bad reaction.

 

Pit Viper venom is Hemotoxic though and it might be a different story when bitten by e.g. a cobra which has neurotoxic venom. I don't know.

[Sheryl]

Not all snake bites result in envenomation so it is indeed common to wait and observe closely first for signs before giving antitoxin.

[nausea]

Identify the snake; that's it really.