Poiionoui Snakei of fho World 



iii<>r|iluiu< to ati iiiiftniM'ioiis viriim or oiic iii 

 ii'spiiiitoi V (list ii'>s. 



.">. Allay aiipiflicnsion \>y it'assniiiit; wduls ami 

 actions. 



(■>. Kt"|i!ato ami niaiiitaiii atlt'nuatu hlood \ol- 

 iiiiio willi saliiu', phiMiia, plasma oxpaiulors, or 

 whole lilootl. ( IliMUS 0, 7, and S i\i(" rt'cominoml(Hl 

 lor use hy meilii-il otlicers or paramedical per- 

 -nmiel with appropriate (iiialilicjitions). 



7. (Jive vasojjressor drugs if condition war- 

 rants. 



S. (live) o.\ygen. 



Rexpirnfonj Dixtresn : 



1. Clear airway. 



•1. .Vpply artificial respiration. .\- lonj:' a> the 

 patient's heart contiiuies to lieal, hi' lias a chance 

 to i-ecover, and thi< may occur c\cii al'ici- many 

 hours of artihcial revpii-ation. .Mouth lo-nmulh 

 iireatliiuir in riiyihm is the method of choice in 

 all cases of respiratory faihne. Ilowexer, wlicn 

 it cannot he applied, the rhytlnuic pusji-pidl 

 methods are fivnerally ellVciive. If a niechani<-al 

 resu>cilator is a\ailaiile, il also may he used hy 

 anyone (inaliiied in its operation. 



■''). Ivespirafory stiunilants are limited to use 

 hy a medical officer. 



Vomiting : 



Vomit in<r frequently oc-curs following; certain 

 types of snake venom i)oisonin<!:. Precautions 

 should he taken to see that the patient does not 

 aspirate vomitus. Place him in a prone position, 

 head slightly lowered and turned to one side. 



Excessive SaUvafion : 



Place head in a position to permit adequate 

 drainage of saliva as described under Vomiting, 

 above. Keep airway clear. Atropine or para- 

 sympatholytic drugs may be administered only by 

 a medical officer. 



Convulsions : 



No treatment should ho given during the attack 

 except that which will ])revent the patient from 

 injuring himself. 



STEP NINE 



Disposition of Patient.— .Vt the aid station or hos- 

 ]>ital, inform the doctor of the identity of the 

 snake involved (if known) ; or, turn the dead, 

 unidentified snake over to the doctor. Give ap- 

 proximate time between bite and arrival and 

 point out any constriction -band or tourniquet left 



in place. (;i\e dclaiU on any anTuenin or drugs 

 gixen the palicni. Ihqinrl all umi^nal signs and 

 symptoms. 



BITES BY 

 UNIDENTIFIED SNAKES 



ICvery atlenqd should h(( made to ca])lurc and 

 kill, or at leas! ident i fy, I he (jll'ending snake. As 

 a lade, snakes remain in I lie \icinity of the ac- 

 cident. .\ knowledge of the habits and habitats 

 of thr Miakes peculiai- to I he area (see Chaptei's 

 \'l. \'ll, and \'II1) will assist in locating and 

 identifying the snake. //'//. when the hile occurs 

 al night, capture of the smdie may not he pos- 

 >ihle. and management and treatment of the vic- 

 tim will depend upon the clinical signs ami 

 symptoms. 



First, have the victim- lie down and remain, at 

 eoinplete rest. Immohilize the Intten pnvt and 

 Irep it in a dependent position. In this position 

 the onset of pain, if it occurs, will be more i'a]iid, 

 thus assisting in an I'arly diagnosis, /'o nut 

 apjihi II toll fiiiijacf or incise titr imiinil. These 

 measures may pi'oduce etTects which could nndce 

 diagnosis more dilticult. 



If no pain, swelling, edema, drowsiness, pares- 

 thesia, weakness, or paresis of the muscles of 

 the face and throat appear within 30 mimites, the 

 bite was piohably inflicted bv a nonvenomous 

 snake. Ilowexer, if at all ]iossil)le, the victim 

 should remain at rest and be oliserved for an ad- 

 ditional 2 hours. 



If syni])toms or signs of venom poisoning de- 

 velop during the observation period, the measures 

 jn-eviously described under General Considera- 

 tions, al)ove, must be considered. The success of 

 these measures will depend upon the time that 

 has transpired between the bite, and their initia- 

 tion. In those cases where the first aid measures 

 have been deferred, the need for early admin- 

 istration of antivenin becomes urgent. In such 

 cases, greater consideration should be given to 

 the intravenous use of antivenin, obviously fol- 

 lowing the necessary sensitivity tests. 



SENSITIVITY TESTS 



A sensitivity test for hor.se serum must be car- 

 i-ied out on all victims of snake venom poisoning 



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