There are two important aspects of snakebite management, one is the first-aid, basically management of snakebite victim, and then the timely medical management (antivenom serum therapy).

Since rural people have to rush to nearby towns and cities to get medical support, precious time is lost in travelling and in organising transport. If one could understand about snakes, prevention of snakebite, the proper first-aid and transportation to the proper medical facility, the fatalities due to snakebites could be reduced effectively.

In absence of any authentic information about snakes & snakebite for common man to deal with snakebite emergencies in India, there are many myths about snakes and snakebites. The snake charmers and feature films with their vested interests, have been adding fuel to the firewith misleading stories about snakes and snakebite.
As a result, people have more trust on false claims of treatment and most of the times people fall prey to quacks’ treatment. Part of the problem when someone is bitten, is the element of surprise, as people are usually not trained to deal with a snakebite emergency. Preparation which includes knowing in advance about the basic knowledge about snakebite and how to get to the nearest hospital– could greatly reduce anxiety and lead to more effective care. The best solution is to educate people - disseminate information about snakes and snakebite - what are snakes, when and why do they bite, how to avoid getting bitten, what to do when bitten, etc. It helps to understand that:

All snakes are not venomous – so every snakebite is not going to result in death – it would save people from quacks. And reduce the amount of panic and chaos.
Even a venomous bite is not always fatal – because the severity of snakebite depends on many factors like the size of the snake, whether the bite could be completed, whether it was a drybite or not, the age, physique and affected limb of the victim.
First Aid would enable a person to buy more time to reach medical aid on time.
The only cure which is available is anti-venom serum injection and not quacks.
First Aid - if not done properly could cause more harm than benefit.
Save the rural innocent/simple people from snake-charmers and quacks.

How to Avoid Getting Bitten:
-Avoid stepping out in the dark, especially during the monsoons, without a torch and boots.
-While walking through knee-high-grass, disturb the grass ahead with a stick to ensure that there are no snakes.
-On trekking and camping trips, while picking up a tree-bark or fire-wood for cooking, be careful about snakes, which may be hiding beneath.
-Wear leather ankle shoes for outdoor activities.
-Keep your bags/haversacks and boots above the ground. Preferably closed to deny entry to snakes, these are good overnight shelters for snakes.
-Before you wear your boots, hold its sole from toe side and bang the heel side on the ground several times to disturb any snake or biting and stinging insects inside and let it go.
-During summer, when there is a scarcity of water, snakes may be attracted to cool spots near tents. So do not wet the soil around tents.
-Rats or other small animals are attracted to left over food at night. Snakes are likely to follow rat tracks. Make sure that your leftover food is thrown far away at a designated area or buried.
-While rock-climbing be careful of snakes in crevices.
-Drain-pipe openings of your kitchen and bathrooms should have fixed mesh caps (not hinged) to deny easy entry to snakes, which may stray in while chasing rats or to hide in cool and dark place. A snake can reach your bathroom via the network of drains.
-Avoid rock-garden and rockery in your lawn. It is the most suitable place for snakes.
-Pathways should be well lit, avoid paving with loose tiles.
-Avoid making water ponds at home.
-All windows should be fitted with mesh.
-Mesh in front of desert-cooler is essential. It is an easy way for a snake to make entry into your house.
-The bottom of doors should have rubber lining, on the outside, to stop the gap, so to prevent any snake creeping in. One of the best ways for snakes to make entry into your house.
-After any construction work at home, remove all the rubbles immediately. It gives shelter to snakes.
-There should not be any vegetation (such as creeper, bush or small tree) touching the walls of the house, which can help a snake to climb to windows and any ventilators.
-Disinfactants with pungent smells, like phenyl may be regularly used to wipe the floor and in the drains. Snakes avoid unpleasant smell.
-In India, mostly, the electric switch for the bathroom is installed inside the batroom. In such situation, anyone visiting the bathroom has to step in dark bathroom first and if there is a snake, one will be bitten for sure. Install electric switches outside the door of your bathroom.
-Snakes love dark and cool places! Eliminate such areas at home.

-As a common man, one should know how to administer proper first-aid to a snakebite victim, without losing precious time.
-Never try to assess whether it was venomous snakebite or not. As a layman one should treat every snakebite as venomous snakebite, as some snake venom (like that of common krait) does not show immediate effect even in the case of a serious bite, it is wise to rush to a hospital.
Even if in doubt about whether it is a snakebite or not, do the first-aid and rush the victim to the nearest hospital.
-Educate your children that putting one’s hand into any kind of burrow could be dangerous.
-Never get into a dark bathroom; first switch on a light and then see around you before you enter.
-Not all bites from venomous snakes lead to death; many venomous snakes (and as many as 85% of snakes are non venomous) deliver only a dry bite to humans. Even in the case of a full bite, with appropriate first-aid, care and treatment a snakbite victim can fully recover. Very few venomous snakebites are fatal. Just as every mosquito bite does not cause malaria, so every snakebite does not cause death.
-No attempt should be made to kill the snake to carry it along to the hospital. It would result in delaying the arrival of the patient to the hospital and is potentially dangerous for the person who will attempt killing the snake. Qualified doctor can diagnose observing the patient for clinical symptoms and pathologial tests.

First Aid & Treatment
Snake venom is actually a kind of highly evolved salivary secretion which is used to both kill and digest prey. Venom was not made against man. There are two basic types of snake venom. One affects the nerves (venom of cobra and common krait); the other one blood (that of vipers). Polyvalent anti-venom serum is effective against the bites of the Big Four – cobra, saw-scaled viper, common krait, Russell’s viper. If a venomous snake bites someone, just remember two things: don’t panic; go to a hospital and get anti-venom serum. Don’t waste precious time on quack’s remedies, tantra-mantras, jhar-phoons, herbal preparations, etc. In case of snakebite, a well-administered first-aid is vital.

The following activities are important:
-Keep the victim calm, restrict movement.
-The limb, which has been affected by the bite, should be immobilized with splint and be kept below the level of the heart. A compression bandage (not tight) should cover the entire limb with the splint.
-Assure the victim and do not let him panic. When under panic, it will enhance heart rate and would circulate the venom faster in the body.
-Remove any rings or constricting items; the affected area may swell.
-A snakebite victim is under tremendous psychological stress. It is necessary to keep the patient warm. However, no alcohol/hot beverages should be given. The patient should not be allowed to exert himself in any manner.
-DO NOT COVER THE BITE AREA AND PUNCTURE MARKS. The wound should be gently cleaned with antiseptic.
-Try to aspirate the venom out of the puncture marks with standard suction devices. It has been identified that a suction more than 270 mmHg can initiate the flow from the puncture marks. -Suction instruments often are included in commercial snakebite kits. But, the suction should be applied within 5 minutes of the bite.
-The only remedy for venomous snakebite is the anti-venom serum, which is available at most government hospitals and public health centers. Some private nursing homes have also started stocking it and treat snakebite cases.

How NOT to Treat Snakebite :
-No ice or any other type of cooling action on the bite. Research has shown it to be potentially harmful.
-No electric cable, string or rubber tourniquets to be used, this cuts off blood flow completely and may result in amputation of the affected limb.
-No electric shock, this method is under study and has yet to be proven effective. It could harm the victim.
-No incision in the bite site. Such measures have NOT been proven useful and causes needless additi onal injury, loss of blood, infection, waste of time.
-Do not burn the wound, as it would not have any effect on the venom, which has already entered the bloodstream.
-Do not suck the wound with mouth. A suction device may be applied over the bite to help draw venom out of wound without making cuts.
-Potassium permanganate should never be used.


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