VENOMOUS SNAKE BITE

Snakebite envenoming is a very serious medical hazard in which the elapsed time from the moment of the bite until the correct monitoring of the patient in a proper medical facility is a determining factor. Hence, when a venomous snakebite has occurred, it is very important to act diligently and to stay calm all the time.

Venomous snakes can be classified in three different families according to the type of dentition:
1. Family Colubridae (subfamily Boiginae): rear-fanged snakes with a venomous apparatus of the opistoglyphous type. The fangs are relatively mobile and are positioned in the posterior or rear part of the upper jaw, and are connected to a venom gland. The Boomslang, all Boiga species and the Montpellier snake among others, are opistoglyphous snakes.
2. Family Elapidae (subfamilies Elapinae and Hydrophiinae): venomous snakes with the proteroglyphous type of dentition; with two short and rigid fangs located at the front part of the upper jaw, each fang connected to a venom gland. Cobras, mambas, coral snakes, sea snakes and Australian elapids are proteroglyphous snakes.
3. Family Viperidae (subfamilies Viperinae and Crotalinae): snakes with the solenoglyphous type of dentition; with two long fangs that are hinged and mobile, each fang connected to a venom gland and located at the front part of the upper jaw. Vipers and crotalids (pit-vipers) are solenoglyphous snakes.

All bites inflicted by exotic venomous snakes (from Africa, Asia, America, Australia and the Middle East) are potentially deadly and must be taken care of with the utmost rigor and extreme urgency, even in those cases when there are no initial signs of envenoming.

Most of the traditional first aid procedures are potentially harmful and the use of them is inadvisable;
• The use of a tourniquet that obstructs blood flow can cause gangrene. Pressure bandages are advisable mainly for elapid bites, because the mayority of these snakes have a neurotoxic venom which does not affect tissues, and therefore there is no risk of causing necrosis.
• Local incisions and suction of the wound may introduce infection, damage tissues and cause persistent bleeding.
• The application of ice over the wound can cause necrosis.
• The use of a vacuum extractor device can cause tissue damage.

To sum up, the only real effective action when dealing with a venomous snakebite is rapid transportation to a medical facility, having previously immobilized the bitten limb if necessary. During transportation to the hospital patients should lie on their left side to prevent aspiration of vomit. It is important at all time to reassure the patient. If the patient is unconscious cardiopulmonary resuscitation must be started.

Because a bite by any of the Iberian vipers is normally not life threatening, the main action should be to reassure the patient and take him to a hospital without delay.