Monday, 25 August 2014

SNAKE BITE

HABITS OF SNAKES

The snake is a limbless creature with a scaly elongated body, colours and patterns on the body blend with surroundings.the progression of the snake is by gliding,moving faster on rough surface than on smooth surfaces.Head having a pair of eyes and a pair of nostrils but no external ears.The important anatomical parts of the snake is,as far as the human health hazard is concerned,are teeth and venom glands of poisonous snakes."envenomation"is the term called for the snake bite poisoning.Snakes eat insects,frogs,rats and mice.The king cobra type of some lives on small snakes and also its own kind.The Mongoose.dogs,cats, eagle and peacock are its natural enemies.Dogs and cats are alerted by its presence and they catch it.
Most snakes are are usually nervous and shy;therefore,they try to escape and hide if disturbed,and attack only if escape is not possible.Some are,however,vicious and attack unprovoked.They are not disturbed in fields and forests and getting of plenty of prey,are more infested than inhabited areas.But rodents may attract them into build up areas.Jung heaps, garbage.and rubbish collections,close to human habitation,offer them
undisturbed shelter and offer them lot of prey.They also live hollow of trees and abandoned and fallen masonry.
Snakes survive starvation for long time and hibernate during severe winters.In tropics they are seen in the open all year round.In subtropics they come out in  summer and more open during rains in search of dry places.most land snake can climb in the tree and swim.Fresh water snakes are nonpoisonous.A medical person should be able to distinguish the poisonous from non-poisonous snakes and a bite from it is required anti venom treatment or not,because,although the anti venom treatment is life saving,it carries a certain amount of risks.If the bite is certainly that from a non poisonous snake the specific treatment can be withheld.The distribution,local names and important distinguishing features of Indian poisonous snakes should be learned by a first aider and he must know the first aid treatment to give to a snake bite case before the arrival of a doctor or the case is being transported to a hospital.
There are about 1000 species of snakes in the world out of which 300 are Poisonous.Out of 400 species of
Indian land snakes 40 species are poisonous,and out of those only 4 per cent only constitute the total population of snakes.Out of 30 sea snakes species in India one species only poisonous.But due to their narrow gape they can rarely bite effectively.The main poisonous land snakes in India are the cobra,King cobra,vipers and the Krait which is most poisonous of all the snakes but least commonly bites a man.The first 3 species cause most of the deaths.But pit vipers in India do not cause many deaths.There are three main types of viper in India namely, Russell s viper,green pit viper and so scaled viper which all can be distinguished by seeing the marks,scales and a pit on the head of green pit viper.Cobras include the common India cobra and king cobra which is forest dweller.The common Indian cobras are found in thick jungles or in open country with or with out vegetation and in gardens or in cultivated lands under rubbish or in old temples and mosques.It is also found in dark rooms of bungalows, homes,when disturbed it tries to escape.A young cobra is much more alert and irritable and strikes and bites and more dangerous than a full grown cobra.Venom of cobra affects nervous system,depresses brain and makes respiratory failure.
Vipers with pits on heads between nose and eyes called "pit vipers" and not having such  pits are
"pit less vipers".Both types are found all over India.There are about 110 kinds of these viper snakes and all are poisonous.but the venom of some of them is not lethal to man.Their poison fangs are well grown and effective for a bite.A viper has a flat,broad and some what triangular head with angles,normally covered with small scales.and eyes vertically.11 kinds of pit vipers are found in Indian sub continent,and 22 kinds are found in Asia out of 65 kinds pit vipers in the world.Indian pit vipers are mostly found in hilly areas and deaths from their bites are rare.The deaths by bites of pit-less vipers are more in India are the Russell's and the Echis vipers.They are easily distinguished by the broad plates extending right across the belly and the small scales on the head like to those on the body.their back marked with black blotches of inverted V shaped markings.No other land  snake possesses all these features combined.Venom of vipers affect on blood and circulatory system and makes hemorrhage/bleeding internally and externally.
Kraits are found more in eastern India than other parts of country,but are found in patches of all over the country.There are two main varieties, the banded and non branded.Kraits has the most potent venom of all
the land snakes,which affects the central nervous system and paralyses of the brain and collapses of lungs and suffer from respiratory failure.But these snakes are inoffensive and shy which bites human beings very rare.It abounds in cultivated fields and human habitations.They have a small mouth and very fine fangs.
Snake venom is a clear, oduorless and fastless liquid.After drying it and adding water to it,it will again become a powerful poison.It acts only through broken surface of skin,mouth,or mucous remembrances.It is like a digestive juice and digests everything except hair,nails and etc.Venom contains four important enzymes.The systemic effects produced by each type of venom is determined by the presence of particular enzymes.A snake can bite number of times successfully and continue to secrete venom,and the amount of poison discharged one time by each bite from a poisonous snake varies from 2-3 drops as in the case of sea snake,and 30 drops as in the case of king cobra.
 The diagnosis of envenomation and its type is made by the time interval between the bite and starting of symptoms,and progression,type of syndrome and local examination of snake.Snake venom is highly potent poison and absorbed into the body rapidly.As all snakes are not poisonous and all bites are not fatal,all snake bitten persons suffer from psychological shock and few deaths may occur due to it.So all bites are considered as poisonous and requiring proper attention.The victim should not exert and should keep calm and reassure the victim.Absolute rest and warmth should be given,and hot tea or coffee may be given.Alcohol and strychnine are prohibited and morphia is contraindicated.It is better to give first on the spot.The victim may call for help or proceed slowly to the place where assistance can be had.A quick inspection and general examination of bitten part may give indication whether poison has been injected.
Treatment depend on correct diagnosis of envenomation and its type.The venom acts very soon if a large
amount is absorbed into the circulation,and anti snake venom serum,which is the only specific remedy,does not get a fair chance and time to neutralize the venom if its administration is delayed ,First aid,therefore, aimed at preventing and delaying absorption of the poison pending administration of the anti snake venom.
The first aid treatment for snake bite is as follows:Remember RRP(REST,REASSURANCE,POSITION)  
If you see a snake bite case locally,give him complete rest,reassure the victim and keep the bitten part lowered if the bite is one of the extremities.Any action walking,running.etc will increase circulation and poison may absorb rapidly in the whole body.Aim of the first aid is, not to enter snake venom into circulation. Wash the part thoroughly by soap and water or with plain water if soap is not available on the spot,This will remove the poison from the site of bite from further absorption to blood.Suck the bitten part by your mouth if mucous membrane in mouth is intact.Then apply a piece thick string of cloth round the limb,on the single bone,above the site
of bite.Tighten it with a stick just enough to stop venous circulation not for arterial flow.This more beneficial
in case of cobra bite than viper bite.suction may be done by breast pump or cupping glass etc,if incisions are made on the part of bite,There is also a controversy that if incision are made in the bitten part, more poison may absorb in circulation.Any way valuable time may not be wasted over these procedures.
The limb should be immobilized with a splint,broad strips of wood or in sand bags or plaster splints.
Thomas splint should be used when patient has to be moved over a long distance for specific treatment.The
envenomation having been diagnosed,the anti snake venom serum should be given with out delay on arrival
to hospitals.
pmkutty


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