This document provides information and guidelines on snake bites and treatment: - If bitten by a snake, remain calm and immobilize the bitten limb. Seek immediate medical help while monitoring symptoms and describing the snake. - Venomous snakes in the region include adders, cobras, mambas, boomslangs and twig snakes. Their venom can be cytotoxic, haemotoxic, or neurotoxic. - Recommended first aid depends on the snake type but generally involves immobilizing the limb, cleaning the wound, and restricting blood flow for neurotoxic bites until medical treatment. Do not apply tourniquets, cut or suck the wound.

1. What to know about snakes
SNAKE BITES...
 If possible, identify the snake or note its characteristics. Do not panic, calm the patient
and allow only the minimum required movement.
 Do not cut and suck the bite wound and no not apply a tourniquet.
 Apply a bandage firmly along the whole length of the bitten limb, from bottom to top,
checking that circulation has not been totally restricted.
 Immobilize a bitten limb and get the patient to hospital
 Keep airways open and do not leave patient alone.
 Treat symptoms as required, e.g. apply mouth-to-mouth or cardio-pulmonary
resuscitation.
 Anti-venom should be administered only under proper medical supervision, if the
snake has been correctly identified.
This information is provided merely as a guideline and the author does not accept
responsibility for incorrect/incomplete information.
SNAKE BIT SENSE
Although less than 10% of the estimated 130 to 160 species of snakes in South Africa are
extremely venomous, and your chance of being bitten by one is slight, it's best to be prepared
- especially during the summer months.
Poisonous snakes found in Mpumalanga are adders, cobras, mambas, boomslang and vine
(also known as twig or bird) snakes. But the chance of coming across these snakes is very
small since they usually quickly disappear as soon as they sense the slightest movement. Puff
adders are the exception however, as these fast striking snakes often lie still and are therefore
easily trampled on.
Take precautions
• Never try to catch or kill snakes.
• Watch where you walk.
• Always use a torch when you walk outdoors at night.
• Wear hiking boots, thick socks and long trousers.
• Step on top of logs or rocks, not over them.
• Stick to footpaths
• Don't put your hand into holes in the ground or under objects when picking them up.
• Stay away from dead snakes as many fake death. If you see a snake, freeze; make no
sudden movements. Then gradually move away very slowly. Most snakes will not

2. waste venom, which takes a lot of energy to produce. If you are too big to eat, they
will try to warn you off before striking, unless they are frightened or very annoyed.
• If you are bitten, don't panic, very serious injury or death is rare unless the bite is left
unattended for several hours or days. However, someone who doesn't receive
treatment after a bite from a big, angry mamba or cobra can die within minutes as
these snakes can deliver lethal amounts of venom to several people at one sitting!
• Get help immediately after a snakebite (unless you're absolutely certain that the snake
is not venomous). Phone the hospital en route to give the staff time to prepare the
anti-venom. Provide a clear description of the snake its color, markings, length, color
of the belly, shape of the head, shape of the tail the reaction of the snake and
geographic area.
Know the symptoms of a snake bite and the appropriate treatment
Types of Venomous Snake Bites
The danger from snake bites and the toxicity of venom that a snake injects in to its victim
varies from species to species. The recommended first aid for snake bites will also vary
according to species and this underlines the importance of being able to place venomous
snakes in to groups according to the properties of their venom. The required treatment for a
snake bite is defined according to whether the venom is cytotoxic, haemotoxic or neurotoxic
and the wrong treatment will not only be of little or no help but could even be dangerous.
CYTOTOXIC: An agent or process that is toxic to cells and suppresses cell function or
causes cell death.
The venom from Adders and Vipers is Cytotoxic. Generally two puncture marks at the site of
the bite. Bite causes instant pain with immediate swelling, bruising and blistering. Symptoms
can include nausea and dizziness.
Treatment:
Immobilise the limb but do not restrict the blood flow
HAEMOTOXIC: An agent or process that kills red blood cells and prevents clotting resulting
in internal and external bleeding.
The venom from Boomslangs and Vine snakes is Haemotoxic. Sometimes puncture wounds
can be seen at site of the bite. Bite is generally not very painful but within one hour copious
bleeding is likely to occur from the bite wound and any other wounds cuts or scratches the
victim may have. Symptoms can include a severe headache, nausea and vomiting

3. Treatment:
Whilst it is helpful to restrict the blood and lymphatic flow it is important not to cause
bruising as this could lead to subsequent bleeding under the skin. If Venom is spat in to a
person’s eyes use any liquid available, preferably a neutral one such as water or milk – but
anything at all will do - and flush out the eye.
NEUROTOXIC: An agent or process that is destructive or deadly to nerves or nervous tissue
The venom from Mambas and Cobras is Neurotoxic. Generally two puncture wounds at the
site of the bite. Bite can feel more like a sting and there is little or no bruising and swelling.
Symptoms include feeling confused, dizziness, slurred speech, difficulty swallowing and
breathing
Treatment:
Immobilise the limb and do restrict blood flow between the bite and the heart. Administer
CPR until Medical help is available.
Do’s and Don’ts of Treating a Snake Bite
Symptoms usually manifest themselves reasonably soon after a snake bite so observation of
the victim is extremely important. If no symptoms have occurred within less than half an hour
of the bite then indications would be that it was not a venomous snake, it failed to inject any
venom or the snake was very old and had little or no venom left.
DO:
• Try to identify the snake; colour, size, shape of head, attacking method are all useful.
• Loosen the Victim’s clothing and, if necessary, move them in to the shade
• Keep the victim calm and still; movement will increase blood flow and transport the
venom to the heart much faster.
• Immobilise the limb but do NOT restrict blood flow unless you are certain the bite
was from a snake that delivers neu- rotoxic venom.

4. • Clean and dress the wound being careful not to apply pressure and cause bruising.
• Be prepared to administer CPR if necessary.
• Get the victim to a hospital as soon as possible
• Remove jewellery, as swelling tends to progress rapidly.
• If the bite is from a cobra or mamba (not an adder such as the puff adder) wrap a
crepe or pressure bandage, a handkerchief or shredded cloth, firmly about 20cm above
the bite. Never apply bands on either side of a joint such as above and below the knee
or elbow. The purpose of the constricting band is to restrict lymph, not blood, flow
and should be regularly checked and readjusted as the affected area starts to swell.
• Wrapping a crepe or pressure bandage firmly around the area of the bite may help,
especially in the case of a mamba or cobra bite. Cover the entire limb (from fingertip
to armpit; from toe to groin) but take care that the bandage does not become too tight
when the limb starts swelling. Apply hand pressure at the site of the bite until a
bandage or strips of fabric can be obtained.
• If a snake spits into a person's eyes, wash the eyes with large amounts of water,
preferably by holding the person's head under a running tap. If water is not available,
use any fluid (even urine) that • is not harmful to the eyes.
• Observe the person and record the symptoms and the time they take to appear.
• Other than keeping the person comfortable, nothing else is needed. Very occasionally
the person's heart may stop if the venom has been injected intravenously. Proceed
with heart massage and mouth-to-mouth breathing until a hospital can be reached.
DO NOT:
While there can be differences of opinion as to what we should do for snake bites the
consensus of opinion as to what not to do is reasonably consistent:
• Allow the victim to exercise or stress themselves.
• Cut the bite or attempt to suck the venom out. It will only damage tissue and cause the
venom to spread through the body more quickly. Give the victim anything to eat or
drink especially alcohol.
• Apply a tourniquet. It can cause the loss of the limb.
• Use potassium permanganate crystals or solution near or on the bite wound.
• Use soapy water round the bite wound.
• Leave pressure bandages on too long
• Leave the victim alone.
• Apply ice to the wound.
• Soak the affected limb in any solutions
• Use anti-venom except in a hospital environment. It may cause adverse or allergic
reactions such as anaphylactic shock and delayed hypersensitivity (serum sickness).

5. • Try to kill the snake