Medical Treatment of Snakebite



Treatment may be necessary if the poisoning is severe. The best treatments to date are species-specific antivenins. If the patient has an adverse reaction to the antivenin or begins to show signs of anaphylaxis, intravenous epinephrine should be administered. Antivenins should always be administered via an intravenous drip so that the dosage can be carefully monitored and ceased as soon as an adverse reaction is discernable. Steroids and cortisone are useful to prevent or slow necrosis. Washing the area near the bite with saline is also advisable, although bandaging the bite is not, due to increased incidence of bacterial infection. In patients experiencing respiratory failure, tracheotomy may be necessary in extreme cases, although artificial breathing, such as CPR, may suffice for less severe instances. Cooling the bite may be helpful at preventing the spread of the venom, but this can also lead to a decreased blood flow and may stimulate infection; there is no definitive evidence for either case.


Antivenins are the only specific treatments for snake venom poisoning that are currently available, and it is vital for severe envenomation. (Minton, 157) The preparation of antivenins requires the addition of the venom of interest with formalin and then the venom is mixed with aluminum hydroxide gel. This is done to prolong the absorption of the venom into tissues. The mixture is then injected into horses over a period of several weeks. The doses are gradually increased such that the horses build up a high level of immunity to the venom. Blood is then withdrawn from the horses and the plasma is separated from the suspended particles. The serum is then refined, processed, and freeze-dried. Antivenin is essentially a concentrated solution of horse-derived antibodies against venom that are used by humans. It is a form of passive immunity, and since it does not increase endogenous resistance to venom, doses must be re-administered as the previous doses wear off. There is always a possibility of an immune response against the horse serum since it contains suspended proteins that can trigger anaphylaxis. That risk is the reason why epinephrine should be available when treating snakebite with antivenin.


Photo by Mardi Snipes


The treatment of snakebites is usually successful enough to prevent death, but not always, and amputations, especially in digits are still common in snakebite victims. The best way to avoid this kind of trauma is to avoid poisonous snakebites by being well informed and aware of your surroundings. Some snakes are more aggressive than others, and it is not wise to handle venomous snakes, as even expert herpetologists are occasionally bitten. A good knowledge of venomous snakes is useful to anyone who travels off the beaten path.


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