98 DANGEROUS MARINE ANIMALS 



ness of the muscles gradually develops. Common complaints during 

 the early stage are "aching", "stiffness", or pain upon movement. 

 There may be little indication of actual weakness at this time. The 

 paralysis which soon follows is usually generalized, but of the 

 ascending type, beginning with the legs, and within an hour or 

 two, involving the trunk, arm and neck muscles. Lockjaw is one 

 of the outstanding symptoms. Drooping of the eyelids is an early 

 and characteristic sign. The pulse becomes weak, irregular, and the 

 pupils dilated. Speaking and swallowing become increasingly diffi- 

 cult. Thirst, burning, or dryness of the throat may also be present. 

 Nausea and vomiting are not uncommon. Muscle twitchings, twist- 

 ing movements, and spasms have been noted. Ocular and facial 

 paralysis may later develop. In severe intoxication, the symptoms 

 become progressively more intense, the skin of the patient is cold, 

 clammy, cyanotic, convulsions begin, and are frequent, respiratory 

 distress becomes very pronounced, and finally the victim succumbs 

 in an unconscious state. The overall mortality rate has been 

 estimated to be about 25 per cent. 



Treatment. The routine incision and suction method as generally 

 used in the treatment of snake bites is not recommended. The vic- 

 tim should avoid all possible exertion. Make the victim lie still. A 

 tourniquet should be applied to the thigh in leg bites, or to the arm 

 above the elbow in bites of the hand or wrist. The tourniquet 

 should be released every 30 minutes. Keep in mind that you cannot 

 cut off the blood supply to an appendage then just walk off and 

 leave it. Transport the victim to the nearest first aid station or 

 hospital as soon as possible. Do not make him walk. The snake 

 should be captured and sent to the hospital for identification. This 

 is a very important step in snake bite treatment. The snake may 

 be a harmless water snake. 



Antivenin therapy should be administered promptly upon arrival 

 at the first aid station. A polyvalent antiserum containing a krait 

 (Elapidae) fraction should be used. There is no specific antiserum 

 for sea snake venom at the present time. The following may be of 

 interest to the attending physician. Twenty ml. of antiserum 

 should be slowly injected intravenously. This should be preceded 

 by cortisone to prevent serum reactions which are frequent, and 

 may be severe. Epinephrine may be required if the cortisone fails 

 to control the situation during the initial stages of a serum re- 

 action. Supportive therapy should be given to prevent secondary 

 shock. 



Bed rest should continue until all indications of envenomation 



