Poijonouj Snaltes of (ho World 



sihli'. I'liK i>iiti'i>iiu< of fiii'li ciisc is (li'|)i'iiilciil , 

 iinioi);; i)lln>r tliin<;s, ii|i<iii (lu' Uiiid i>( Irciilnifni 

 iisihI mill llin spi'i'd witli wliidi il is inilialcil. 

 AIm)vo all, llio \iclim slioiild ii'iiu'iiilicr (o /i-icp 

 roil/. ;niil luiisidt'r t'licli move I lioioujjjhly. 



STEP ONE 



Apply a Constriction-band or a Tourniquet.— In ciiscs 

 of t'liviMioiiiutioii by most crotiilids, a const rid ioii- 

 l)and slioidd bo [)hiced above the first joint proxi- 

 mal, or 2 to 4 inches proximal to tiie bite, 

 whiclu'ver is a[)propi'iate (see tifj. -2). It siiould 

 be applied tiijht enou<;h to occlude the superficial 

 \enous and lymphatic return but not arterial 

 lldw. It siiould be I'eleased for 90 seconds every 

 10 minutes. The constriction-band can be moved 

 in advance of the progressive swelling. It should 

 be removed as soon as antivenin has been started. 

 In no case of viper venom poisoning should a 

 lonstriction-band be used for more than 4 hours. 

 It is probably of little value if applied later 

 than -V) minutes following the bite. 



FiGiKE 2. — Correct placement of a tourniquet. It 

 siiould be tight enough to impede the fiow of lymph 

 and blood in the superficial vessels, but not that of 

 blood in the deeper ve.ssels. 



Following envenomation by elapids, constric- 

 tion-bands or tourniquets are of questionable 

 vahie. However, in cases of severe envenomation 

 by cobras, kraits, mambas, tiger snakes, death 

 adders or taipans, a tight tourniquet should be 

 applied innnediately proximal to the bite and left 

 in place until antivenin is given. It should be 



|■l•ll•a-^l■d Idr '.10 seconds evci-y JO nilnnlcs, and 

 -liiinlcj mdI be u.si'd for more liian S iioius. 



STEP TWO 



Capture the Snake and Kill It.— Most snakes will 

 I'cniain in llic iinincdialf^ area f)f lh(^ accident 

 an<l can lie funiMl without l<io iiin<-li dillicidty. 

 If several jjersons are pirsent, send one or two in 

 search of the snake while the others are admin- 

 istering lii'st aid to I lie \iciini. lOxercise e.xtreme 

 caution in hunting for the od'ending snake. A 

 reptile thtit has hitfen once ii jtixf as likely to hite 

 (igain as not. The snake can be killed by a sharp 

 lilow on the neck. (An undamaged head is a 

 great aid to identification). Do lyot handle the 

 snake. If it cannot be positively identified at the 

 scene of the accident, carry it on a stick or in a 

 cloth bag to the command post or hospital. 



STEP THREE 



Lie Down.— Remain at rest until the offending 

 snake has been identified (see Chapters VI, VII, 

 and VIII). If the snake is nonvenomous, clean 

 and dress the wound and proceed with your mis- 

 sion. Report to a medical officer as soon as 

 ))0ssible. 



If the snake is identified as venomous, or if its 

 identity cannot be determined, begin treatment as 

 outlined below: 



STEP FOUR 



Unidentified Snake.— Innnobilize the injured part 

 (see below) then turn to page 16 for instructions. 



Identified Venomous Snake.— Immobilize the in- 

 jured part. This can be done by splinting as for a 

 l)roken arm oi' leg. The immobilized part should 

 then be kept below the level of the heart, but not 

 in a completely dependent position. If the wound 

 is on the body, keep the victim in a sitting or 

 lying position, depending on the location of the 

 bite. The patient should always be kept warm. 

 He should not be allowed to walk. He should 

 not be given alcohol. He may, however, be given 

 water, coffee, or tea. Any manifestations of fear 

 or excitement should be alleviated by reassurance. 



STEP FIVE 



Make Incision and Apply Suction.— Incision and suc- 

 tion are of definite value when applied immedi- 



14 



