1-9.
TREATMENT OF REPTILE BITES
a. The severity of the symptoms depends on the amount of venom injected by
the reptile and whether it was injected into a blood vessel or into the muscle or fatty
tissue. Within practical limits, achieve immediate, absolute immobilization of the
affected part in a position that is at the level of the heart or slightly lower. Place the
patient in prone position, reassure him and keep him as calm as possible, tell him not to
move, explain to the patient what you are doing and tell him that evacuation will be
accomplished as soon as possible. If the patient has been bitten on an extremity, keep
the bitten part at or below the heart level to slow down the spread of the poison to the
heart.
b. Place an improvised, lightly constricting band (shoestring, bootlace,
handkerchief, strip of cloth, etc.) 2-4 inches above and below the site of the bite (Figure
1-7). If the bite is on an extremity (hand or foot), place the constricting band 2-4 inches
above the site of the bite. Place this constricting band tight enough to obstruct ONLY
lymphatic flow since the absorption of venom is predominantly by lymphatics. DO NOT
RELEASE the band for the first 30 minutes, but then release the tourniquet for 2-3
minutes qlh. You should be able to insert a finger between the constricting band and
the limb. If swelling progresses up the extremity, remove the band and reapply above
the swelling. If at any time the victim stops breathing, give him mouth-to-mouth
Figure 1-7. Placing constricting bands.
c. Kill the reptile if possible, preferably without damaging its head;
however, there is no need to kill the reptile if you can properly identify it. Save the entire
snake so that a positive identification of the reptile can be made when the patient
reaches a physician. If the reptile escapes, obtain a description so it can be used to
determine the proper antivenin to be administered. The nonpoisonous snakes have
four to six rows of teeth and do not have fangs. (See Figure 1-8.) Pit vipers have two
rows (1 set) of teeth and fangs that create puncture wounds. (See Figure 1-9.)
MD0588
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