Treatment for Snake Bites
Snake bite outcome in the US is much more favorable than the rest of the world. Fatalities from snake bites around the world are very high. This fact underscores the preparedness of the medical system in the US and underlines that prompt and proper care can be life saving.
In the US and North America pit vipers are the most common venomous snake bites. The pit viper venom contains certain enzymes that can cause skin necrosis, tissue necrosis, disseminated infection and systemic shock.
Snake bites from pit vipers should be treated as follows:
- Incision and drainage of the wound if within the first hour from the time of injury. It is usually rarely the case that a patient will go to an emergency room within an hour from the time of injury.
- Loose tourniquet application after 1 hour from the time of snake bite injury. “Loose” is the key word here. A loose tourniquet can reduce the spread of the venom in the affected extremity by 50%. If however the tourniquet is tightly applied then it cause additional tissue damage to the affected extremity.
- Surgical debridement is the mainstay of management of this type of snake bite, just like other animal bite wounds. Incision of the affected skin, pressure irrigation and debridement of affected soft tissues offers the best chance for improvement. Following envenomation the venom stays in the subcutaneous tissues for many hours so excising that tissue is important. This will likely cause prominent and significant contour irregularities and cosmetic defects that can be treated at a later time.
- Broad-spectrum antibiotics and tetanus should be given in snake bites just like other animal bites.
- Antivenin: Antivenin is a very toxic medication capable of causing serious complications upon administration. It should be considered only in critically ill patients who have had snake bites.
Snake Bites from Coral Snakes
Coral snakes envenomation contains acetylcholine esterase.
Acetylcholine esterase causes muscle paralysis. When the respiratory muscles are affected than can lead to respiratory failure and death. Therefore these patients require urgent transport to a tertiary care hospital that can provide all therapeutic and supportive care.