MANUAL MINORS
Snake bites can be venomous or non-venomous, and venomous snakes can cause serious envenomation if not treated promptly. Snake venoms contain toxins that can damage tissues, interfere with blood clotting, or cause muscle paralysis. The severity of the bite depends on the snake species, the amount of venom injected, and the location of the bite.
Diagnosis
Diagnosis is based on the history of contact with a snake, along with the presence of two puncture wounds on the skin (bite marks). Local symptoms include intense pain, swelling, redness, and, in some cases, tissue necrosis. Systemic symptoms vary according to the type of venom and include dizziness, nausea, difficulty breathing, clotting disorders, muscle paralysis, or shock. Blood tests may show coagulation abnormalities and other signs of envenomation.
Differential Diagnosis
Condition | Key Difference |
|---|---|
Insect sting | Pain and swelling, but without puncture wounds or severe systemic effects like those from snake venom. |
Cellulitis | Skin infection with redness and swelling but not related to a snake bite. |
Animal scratch | Linear wound without venom or systemic effects like those in snake bites. |
Allergic reaction | Generalised symptoms like hives and anaphylaxis, but no bite or venom involved. |
Emergency Management
Initial management includes immobilising the affected limb to reduce venom spread. The patient should be kept at rest and transported immediately to a medical facility. Tourniquets or incisions to the wound should not be applied. The bite site should be cleaned with soap and water.
If the snake is venomous or envenomation is suspected, the administration of specific antivenom is the treatment of choice. Pain can be managed with analgesics, but NSAIDs should be avoided due to the risk of increased bleeding.
Definitive Treatment
Definitive treatment depends on the severity of the bite and the amount of venom injected. In cases of severe envenomation, intravenous antivenom is administered. Follow-up includes close monitoring of blood clotting, kidney function, and other affected systems.
Antibiotics are not routinely recommended but may be needed if secondary infection occurs. In some cases, surgery may be required to debride necrotic tissue or manage local complications like compartment syndrome. Long-term rehabilitation may be necessary to restore function to the affected limb.
Comments