First Aid 



to determine whctliei' or not the measures are use- 

 ful, since the time of making the cuts and the 

 duration of the suction are seklom recorded. Al- 

 so, observations in Asia and Africa indicate that 

 these procedures are seldom carried out in what 

 one niiglit assume to be an effective manner. It 

 would seem best to avoid using incision and suc- 

 tion for elapid venom poisoning until current 

 experimental work on this problem has been com- 

 pleted, or until a critical evaluation of clinical 

 cases has been made. 



EXCISION 



Excision of the bite area is a rather heroic 

 measure which might be of value in some en- 

 venomations if it could be carried out within 2 

 or 3 minutes following the bite. It is a procedure 

 carrying considerable risk. It might be consid- 

 ered in those cases where envenomation by a large 

 krait, mamba, taipan, death adder, or tiger snake 

 has occurred, and where the victim is alone aiul 

 isolated, and likely to remain so for 6 or more 

 hours. Under such conditions it might be wise 

 to excise the wound or amputate the toe or finger. 

 This has been done by some courageous persons. 



OTHER MEASURES 



According to Russell and ScharfTenburg, some 

 217 "cures" for snake venom poisoning have been 

 described in the literature. Some of the suggested 

 first aid measures are: injecting potassium per- 

 manganate, anunonia, vinegai- or oil into the 

 wound; wiapping tlie li\er of tiie oti'ending 

 snake or of a freslily-killed cliickcn over the 

 woinid; setting fire to the wound after applying 

 gasoline; eating various plants oi' raw meat; 

 applying nuul packs to the wound; soaking the 

 injured part in excrement; washing the wound 

 with plant juices; drinking whiskey; taking anti- 

 histaminics, ef cefcrii. These and the other so- 

 called cures are little more tlian historical curi- 

 osities. Whatever the source, tliey are hazardous: 

 first, because they often inxolve dangeious meth- 

 ods; second, because they tlelay the use of effec- 

 tive therapeutic ]irocedures. They should not 

 be used. 



Snake venom poisoning is an accident highly 

 variable in the gravity of its results. It is one in 

 which the most fantastic remedy may gain its 

 reputation among credulous people by having 



"cured" a bite that required no treatment what- 

 ever. Avoid using any first aid measure that has 

 not been evaluated; remember, most of the 

 "cures"' you will hear about have been evaluated 

 and found to be useless. 



REFERENCES 



BUCKLE^', E. and PORGES, X. 1956. Venoms. 

 Amer. Assoc. Advancement Sci., Washington, 

 B.C. W7 p. 



GEXNARO, J. F., Jr. 1!)C)3. Observations on 

 the Treatment of Snakebite in North Amer- 

 ica, p. iiT—i-iCt. In, II. L. Keegan and W. V. 

 Macfarlane, Venomous and Poisonous Ani- 

 mals and Noxious Plants of the Pacific 

 Region. Pergamon, Oxford. 



KAISER, E. and MKTIL, U. 1958. Die Bio- 

 chemie der Tierischen Gifte. F. Deuticke, 

 Wien, '258 p. 



KEEGAN, H. L. and MACFARLANE, W. V. 

 (editoi-s) lOfi;?). Venomous ami Poisonous 

 Animals and Noxious Plants of the Pacific 

 Region. Pergamon, Oxford. 45(> p. 



MERRIAM, T. W., Jr. 19G1. Current Concepts 

 in the .Management of Snakebite. Mil. Med. 

 l-2r):5i>r)-5;51. 



NATIONAL ACADEMY OF SCIENCES, NA- 

 TIOX.VL RESEARCH COI'NCIL, COM- 

 MITTKK ON SNAKEBITE TIIER.VPY. 

 19():'.. Iiueiini Statement on ."^luikebite 

 Therapy. Toxicon 1:81-87. 



PI nS ALIX, ^r. 1922. Animaux Venimeux et 

 \'enins. Masson, Paris, 2 vol. 



REID, n. A., THEAN, P. C, CHAN, D. E. and 

 BAH ARAM, A. R. 1963. Clinical Effects 

 of bites by Malayan viper (Aiwiftrodon rho- 

 (loxtomii). Lancet 1:617-621. 



RTSSELL, F. E. 1902. Snake Venom Poisoning, 

 vol n, p. 197-210. In, G. M. Picrsol, Cyclo- 

 pedia of Medicine, Surgery and the Special- 

 ties. F. A. Davis, Philadelpliia. 



RUSSELL, F. E. and SCHARFFENBERG, R. 

 S. 1964. Snake Venoms and Venomous 

 Snakes. Bil)liographic Associates, West 

 Co\ina, California. 220 p. 



19 



