Of the Cape Peninsula

Transcription

1 Of the Cape Peninsula (Which can be Fatal to Humans) Common Name Scientific Name Type of Venom Immediate first Aid Cape Cobra Naja Nivea Neurotoxic Venom Pressure bandage, immobilise limb, transport to hospital immediately, support breathing Puffadder Bitis Arietans Cytotoxic Venom Pressure bandage, immobilise limb, transport to hospital Boomslang Dispholidus Typus Haemotoxic Venom Pressure bandage, immobilise limb, transport to hospital Rinkhals Hemachatus Haemachatus Neurotoxic Venom Pressure bandage, immobilise limb, transport to hospital List of Venomous Snakes of South Africa A few points to remember: Humans kill many more snakes than snakes kill humans. You are statistically more likely to be struck by lightning or kicked to death by a donkey than to die of snakebite. More people die of human bites in South Africa than of snake bites. Leave the snake alone - and it will leave you alone. Most bites occur when people attempt to kill snakes. A snake bite does not necessarily mean an envenomated bite - injection of venom is under the snake's control. Should you be bitten - remain calm under all circumstances. Panic and shock are bigger killers than venom.

2 How to avoid being bitten by snakes Look ahead and scan the path or area you are about to cross. A general awareness in the bush will do much to help you see a snake in good time. Do not step over logs and larger rocks because a snake could be basking on the other side. Step onto such obstacles. When making your way through long grass and thick bush, wear long trousers, boots or stout shoes. Do not venture abroad at night without footwear and a good torch. Never put an unprotected hand down a burrow or hole in the ground because a snake may be using this as a lair. If you come across a snake, leave it alone because it will be far safer for you and those with you. Attempts to kill the snake are far more likely to result in injury to you and your companions. When the panic-stricken hurl rocks and shoot at snakes, the risk of an accident is increased. Stand still or back away slowly. Do not tamper with seemingly dead snakes. Never handle an apparently dead snake with bare hands. Rinkals are experts at feigning death. They may even twist themselves upside down and lie with their mouth open and the tongue lolling out. Adders may remain quite immobile despite provocation and then strike very rapidly. If your home borders on bush, do not leave piles of rubbish lying about. Pieces of corrugated iron, asbestos sheeting, piping, crates and cartons provide excellent cover for snakes and their prey. Keeping your property tidy will make snakes easier to see and discourage those traversing your grounds from staying either to seek shelter or prey. It is also easier and safer to kill a dangerous snake on open ground. If you are starting to keep or already keep snakes for a hobby, do not believe that they will get to know you and become less dangerous as time goes on. They may well become tamer in the sense that they do not head for cover in the cage as you approach and individual snakes may allow you to handle them. To show that you can handle a dangerous snake like a harmless snake is foolish and exposes you to the risk of serious injury. No matter how tame you think a snake has become, remember that a quick movement made unconsciously near it will precipitate an instinctive strike.

3 FIRST AID in SNAKEBITE: DO NOTS DO NOT INJECT ANTIVENOM. Unless you are hours away from a physician or medical facility anti-venom should not be injected by the layperson. Anti-venom is refined from horse serum and a percentage of people are highly allergic to it. Anaphylactic shock WILL kill your patient - whereas the patient stands a good chance of surviving the bite without anti-venom. Anti-venom is best left to the professionals in a proper facility where life-support systems are available. It should normally be unnecessary for the layperson to use anti-venom anywhere within the Peninsula. DO NOT CUT INTO THE BITE All you will probably do is assist the venom to spread more rapidly. DO NOT SUCK ON THE BITE If you have cuts in your mouth there will be two patients where there was one. If you have a suction device it may be applied or you can attempt sucking through a dental dam - should you have one handy. DO NOT APPLY ELECTRICAL SHOCK TO THE PATIENT A myth has grown up that application of shock or a stun gun is of assistance. This is a pure myth without any basis in fact whatsoever. You are more likely to kill than cure using this method. DO NOT GIVE DRUGS OR INTOXICANTS TO THE PATIENT Unless advised by a medical practitioner. Application of these substances make diagnosis far more difficult once you arrive at the hospital. DO NOT RUB TOPICAL SUBSTANCES INTO THE WOUND You may clean the wound with a little mild disinfectant and dress it lightly with something like Betadine ointment - but preferably leave it alone.

4 DO NOT APPLY A TOURNIQUET You are likely to do far more damage with the tourniquet than without. DO NOT APPLY ICE OR HEAT TO THE WOUND Neither is of any use - but both may harm. Shock - How to Recognise and Treat Shock is a condition in which the circulatory system fails to circulate blood throughout the body properly. It is a progressive deteriorating condition that can be fatal. It is present to some degree in ALL physical trauma Shock CAN kill. The first indication that a person is going into shock is restlessness or irritability. Some of the symptoms of shock are: Heavy or difficult breathing Rapid breathing Racing or Pounding heartbeat Rapid, weak pulse Excessive sweating Pale or bluish skin Excessive thirst Nausea, vomiting Drowsiness or unconsciousness. Although it is impossible to care for shock by first-aid alone, you can take measures that could be life-saving. First-Aid Treatment for shock is: Reassure the victim and keep him/her calm. Help them rest comfortably (pain can intensify the body's stress, which accelerates shock). Have the victim lie down. Keeping them comfortable is the key. Keep your patient from becoming overheated or chilled. If a source of cold water is nearby, wet a cloth and wash their face regularly and lie them in the shade. If it is a cold day, wrap them in a blanket. If you sense that the victim is slipping into unconsciousness, take measures to prevent this from happening. Above all, keep the victim comfortable! Strike up a conversation with them and continue to reassure them. Once shock sets in, the victim's condition will continue to deteriorate, so getting help or getting the victim to help ASAP is the most important thing.

5 The first aid of choice, in snakebite, is the pressure bandage The aim of the pressure bandage is to immobilise the limb and restrict the flow in the lymphatic system. This will slow the transport of the venom dramatically giving you the few hours extra to transport the patient to a well-equipped facility where medical practitioners can take over. A word of advice - many medical men have never seen or treated snakebite. It is fairly rare. Telephone your nearest Poison Centre, University or Snake Park. They usually are able to give advice on physicians with experience of handling snake envenomation. You may ask the treating physician to consult with such a person. Application of the pressure bandage: Get the victim to lie down immediately. Relax and reassure them. Keep calm yourself - you will have enough time. Talk soothingly and be confident. Using a crêpe bandage (or torn up strips of material) bandage the bitten limb. Start at the bite site and work upwards. Do not remove clothes as the movement required will assist the venom to spread. Wrap the limb as tightly as you would for a sprain. Firm, but do not cut off the blood supply. Apply a splint to the limb to immobilise it. Avoid massaging or rubbing the bite area. Do not remove the pressure bandage until medical personnel are ready to start treatment. A VICTIM OF A PUFFADDER BITE TO THE ANKLE IS MADE TO LIE DOWN IMMEDIATELY A PRESSURE BANDAGE, STARTING AT THE BITE SITE, IS BEGUN

6 THE WIDE CREPE BANDAGE IS BOUND AS TIGHTLY AS FOR A SPRAIN THE BANDAGE IS TAKEN AS HIGH UP THE LIMB AS POSSIBLE A SPLINT IS APPLIED TO THE PRESSURE-BANDAGED LIMB THE SPLINT IS BOUND TO THE LIMB SO AS TO IMMOBILISE IT COMPLETELY THE LEG IS NOW COMPLETELY IMMOBILISED BY THE SPLINT THE PATIENT IS NOW READY TO BE TRANSPORTED TO A HOSPITAL

7 Some things to do Make a note of the time the bite occurred. This will help physicians to check on the progress of the venom. Remove constricting jewelry. Rapid swelling may make such items as rings and bracelets into objects of great pain. If possible phone ahead and clearly explain to the hospital that a possible snakebite case is on the way. If a positive identification of the snake can be made, make sure they know what to expect. Be prepared to render artificial respiration in the case of a cobra bite. A dangerous sign of impending lung paralysis is when the victim cannot blow out a match held at arms length. The venom does not kill - the inability to breathe is what causes death. Be prepared to keep the airways open and make sure the patient does not drown on his own saliva. Keep the patient as immobile as possible and transport to a hospital. In the case of a Cape Cobra - you want to get there as fast as possible whilst in the case of the other dangerous snakes of the Peninsula, you have time to drive carefully to the nearest major medical facility. Keep in mind that shock is probably present in all snakebite cases, whether from venomous or non-venomous species. Shock can kill even more rapidly than snake venom. Acquaint yourself with the symptoms of shock. Be prepared to deal with shock symptoms in ANY snakebite victim. Even those bitten by non-venomous species. People have died of such bites in the past. Ensure that a tetanus shot is administered whether the snake was venomous or not.

8 MEET THE VENOMOUS SNAKES OF THE PENINSULA Naja Nivea - Cape Cobra, Geelkapel, Koperkapel. The Cape Cobra is a small cobra, rarely exceeding 1.5 metres in length. It is the only cobra likely to be encountered on the Peninsula, excepting the Rinkhals which is very rare and not a true cobra - or cobras recently escaped from collections. The treatment for all cobra bites is, in any case exactly the same. Cobras are distinguished by their large hoods which are spread when the snake is agitated. It is a slender, nervous snake that readily defends itself by biting. It spreads a large hood. The colour varies from black through to buttermilk with an almost infinite number of variations inbetween. It can be speckled or uniform in colour. Juveniles have a broad black band on the throat which fades with age. Cape Cobras are known for their habit of entering residences to shelter from the heat. They are mainly terrestrial but do climb trees and can swim quite well. They are territorial snakes and tend to frequent the same places. A first line of defense by this snake is to rear up and spread its hood. It may hiss quite vigourously. Its sense of sight is poor and if you remain quite still it will eventually move off. They are said to be more aggressive during the mating season - which is usually from September to October. A bite from a Cape Cobra constitutes a grave medical emergency. Its venom is as potent as a Black Mamba's - but it injects less of it. Transport the patient as rapidly as possible to a medical facility after pressure bandaging. Be prepared to support breathing. You should have at least an hour before dangerous symptoms begin to manifest themself.

9 Bitis Arietans - Puff adder, Pofadder A large, sluggish, thick-bodied snake that rarely exceeds a metre in length. Colouration is varied and ranges from dull grey with barely discernable markings through to light brown with yellow and white chevron markings. Responsible for many bites as this snake relies on its camouflage for protection and does not move off readily when approached. Thus it is often stepped upon. The venom is potently cytotoxic and a bite from it is a fairly serious medical emergency. It may take hours before symptoms start to develop. Pressure bandage and transport patient to the nearest large medical facility.

10 Dispholidus Typus - Boomslang Potentially one of the most dangerous snakes. However its usual placid disposition means it seldom attempts to bite. Most of its victims have been snake handlers. A snake that is easily identified by its large eyes. It comes in a wide variety of colours ranging from dull olive-brown through to bright emerald green with blue and orange. Seldom exceeds 1.5 metres in length. It is an arboreal species and is often seen in trees - hence its name of "boom" slang. The venom is dangerously haemotoxic and destroys the coagulant properties of the blood. It does not respond to the SAIMR polyvalent anti-venom. A special monovalent antivenene is available and works extremely well.

11 Hemachatus Haemachatus - Rinkhals Very rare on the Peninsula although two small isolated populations are thought to exist in Kenilworth and Killarney. It is a smallish cobra-like snake rarely exceeding 1.2 metres in length. It is not a true cobra but occupies a genus all of its own. It differs from cobras in the fact that it gives live birth (vivaparous) and its scales are "keeled" which means they have a ridge running down the centre of them. Important skelatal difference exist also. Colouration tends to be a dull dark-grey with blackish underparts. It will rear up and spread a hood. If this does not scare an attacker off it will spit venom, quite accurately. Should the venom enter the eyes it will burn quite fiercely - and complications may arise if not treated rapidly. Immediately irrigate the eye with whatever liquid you have handy. Water, milk, beer, cooldrink - even urine will do failing anything else. The Rinkhals is seldom implicated in any bites - and those usually only occur when it is picked up and handled. It tends to sham death. Leave all "dead" Rinkhalses strictly alone! It is controversial whether this snake has ever been implicated in any deaths. Pressure bandage and transport to hospital. PLEASE NOTE THAT THIS SNAKE IS NOT CONSIDERED A MAJOR THREAT DUE TO ITS SCARCITY AND WEAKER VENOM

12 Venoms: Snake venoms are a modified form of saliva. They consist of a complex mixture of toxins, proteins and enzymes. They are usually well adapted to killing or immobilising the usual prey of a particular species. No snake venom is a pure substance with a single action. The actions of the venoms of the Peninsula snakes are: Neurotoxic - Nerve acting poison Cytotoxic - Cell acting poison Haemotoxic - Blood acting poison Neurotoxic venom paralyses the musculature. Early warning symptoms are tingling in the lips, inability to swallow saliva and increasingly difficult respiration. The pupil dilates and does not respond to light. The action of such venoms is usually fairly rapid with severe symptoms manifesting themselves within hours in most cases. Cytotoxic venom destroys the cells - usually causing massive necrosis or death of large parts of flesh. Adders have long fangs and this means the venom can be injected quite deeply into the tissues. Necrosis in a puffadder bite. Massive tissue bleeding in victim of a boomslang bite. Haemotoxin causes the prolongation of blood clotting time or destroys the ability of the blood to clot at all. The victim suffers massive tissue bleeding and huge "bruises" develop all over the body. Blood oozes from all mucous membranes. It is slow acting and responds rapidly to the correct anti-venom. In severe cases massive transfusions of whole blood may be necessary.

13 Where to go, who to call, if you have been bitten Institution Phone Number (Cape Town area code 021) Poison Unit, Red Cross Hospital Groote Schuur Hospital, Casualty Tygerberg Hospital, Poison Unit Constantiaberg Mediclinic, Casualty /