The Australian and New Zealand Committee on Resuscitation (ANZCOR) makes the following recommendations in summary for Australian Snake Bites:
1. Send for an ambulance.
2. Keep the person immobilised (still), reassured and under constant observation.
3. Apply pressure bandaging with immobilisation using the PIMS system.
4. Sudden collapse with cardiac arrest requires immediate CPR and DRSABCD protocols.
Many of the snakes found in Australia are capable of lethal bites to humans. These include Taipans, Brown snakes, Tiger snakes, Death Adders, Black snakes, Rough Scaled snakes and many Sea snakes.
New Zealand does not have any native snakes, but snake bites may rarely occur in New Zealand, for example, in zoos or at ports where they have managed to hide in shipping containers or find their way ashore from ships delivering cargo from other countries.
Snakes produce venom in modified salivary glands, and the venom is forced out under pressure through paired fangs in the upper jaw that act like hypodermic syringes to release venom into the bite site. Snake venoms are a complex mixture of many toxic substances that can cause a range of effects in humans. The greatest threat to life and cause of over half of deaths is early cardiovascular collapse. In the 16 years to 2016, 16 Australians were snakebite victims and recorded as dying of snakebite in Australia.
Other Significant Effects Of Snake Bites Include:
• Major bleeding due to inability to clot blood
• Nerve paralysis leading to respiratory muscle paralysis
• Muscle damage, swelling and redness
• Kidney failure due to microscopic blood clots
How To Recognise A Snake Bite
The bite may be painless and without visible marks. Limbs, including the fingers and toes, are often bitten by a snake as they are easily accessible. Not all bites inflict puncture wounds; some snake bites are classed as dry bites. Other signs and symptoms of a snake bite may include:
• Paired fang marks, but often only a single or scratch mark may be present. Localised redness and bruising are uncommon in Australian snake bites.
• Headache
• Nausea and vomiting
• Abdominal pain
• Blurred or double vision or drooping eyelids
• Difficulty in speaking, swallowing or breathing
• Swollen tender glands in the groin or armpit of the bitten limb
• Limb weakness or paralysis
• Respiratory weakness or respiratory arrest
The most common cause of death from snake bites is cardiac arrest. This can occur within 10 to 60 minutes of a bite with envenomation, is most often pre-hospital, and requires immediate CPR. Antivenom is available to treat all of Australia’s deadliest snake bites.
An occasional feature of a brown snake bite is initial collapse or confusion followed by apparent partial or complete recovery. It often occurs as the only finding after a bite from a brown snake and maybe the only evidence of envenomation. This information may be useful when providing handover to the treating health practitioner considering antivenom administration.
What Is The Best Snake Bite First Aid Management
If the person is unresponsive and not breathing normally, there is a chance the venom has entered the lymphatic system and caused a cardiac arrest. Follow the ANZCOR Basic Life Support DRSABCD protocols for resuscitation. Apply a pressure immobilisation technique and wrap the entire limb firmly, allowing for blood flow, not as a tourniquet to prevent blood flow.
If the person is unconscious and breathing normally:
• Send an ambulance for any person with a suspected snake bite
• Keep the person immobilised (still), reassured and under constant observation
• Apply pressure bandaging with immobilisation. Refer to ANZCOR Guideline 9.4.8
• Commence CPR if a person is unresponsive and not breathing normally. There is no risk of transmission of venom to the rescuer by providing CPR.
Note:
• DO NOT cut or incise the bite
• DO NOT use an arterial tourniquet
• DO NOT wash or suck the bite
Snake Identification
Many of Australia’s snakes are protected species. It is strongly recommended that no attempts be made to kill the snake due to the risk of multiple bites or another person being bitten. A digital photograph of the snake may be helpful in identification if you are not able to identify the species.
Antivenom is available for all venomous snakes native to Australia but must be given under health professional supervision in a properly equipped medical facility. Antivenom is not routinely available in New Zealand.
