Chandigarh, August 16, 2004: With various reports of snakes being found in residential areas and the reported death of 2 persons in Chandigarh and Kurali from snake bites, Fortis Hospital, Mohali, today released an Advisory on snake bites, as part of its social commitment to help the general public.

According to Dr. Vikas Bhutani, MD, Consultant - Internal Medicine, Fortis Hospital, "Poisonous snake bites are medical emergencies and can be dangerous, if not attended to quickly. Because of their smaller body size, children are at a higher risk of death or serious complications.

If a poisonous snake bites a person, the most important thing is not to let him panic and remain calm. Make him lie down and stay as quiet and still as possible as any physical activity may increase the flow of venom to the bloodstream. If the area of the bite begins to swell and change color, the snake was probably poisonous.

Wash the bite with soap and water. Immobilize the bitten area by applying a splint on an arm or leg that was bitten; this is intended to limit motion and thus limit the flow of venom into the bloodstream. If possible, keep the bitten area at or slightly lower than the level of the heart. Remove any jewellery on the bitten limb as the limb might swell, making it more difficult to remove after swelling begins. Monitor the person's vital signs - temperature, pulse, rate of breathing and blood pressure if possible. If there are signs of shock (such as paleness), lay the victim flat, raise the feet about a foot, and cover the victim with a blanket.

Get medical help at the earliest. Immediate home treatment should not delay transport to the hospital emergency as anti-snake venom is the only specific therapy available for snake bite poisoning and should be given to every victim at the earliest. The systemic effects of poisoning usually start within 15 minutes to 12 hours of the snake bite.  If the victim is unable to reach medical care within 30 minutes, a bandage/crepe bandage, wrapped 2 to 4 inches above the bite, may help slow venom absorption into the bloodstream. The bandage should not cut off blood flow from a vein or artery. A good rule of thumb is to make the bandage loose enough so that a finger can slip under it. A suction device may be placed over the bite to help draw venom out of the wound without making cuts. Care should be taken NOT to apply incisions or cuts on the bite wound, not to torniquet the affected limb tightly and not to apply ice over the wound site as these measures can be potentially harmful. If possible, try to identify the type of snake which has bitten the person, as all snakes are not poisonous."

Around 230 species of snakes are found in India, out of which only 50 are poisonous and only 6 species are responsible for clinically significant snake poisoning. The differentiation between poisonous and non-poisonous snakes is important. Poisonous snakes can be identified from the broad ventral scales, which cover their belly completely, and two fangs through which the venom is injected. Non-poisonous snakes usually have a blunt tail, solid teeth, semi-circular scales and no fangs.

Mortality figures in India from snake poisoning range from 15,000 to 40,000 per year. However, this being a predominantly rural problem, the figures are conjectural because of variable reporting of the same. Krait bites are usually painless, nocturnal, unprovoked, happen indoors and cause neuroparalytic complications. Cobra  and  Viper bites are painful and cause neuroparalytic and haematological complications.

All snake species will bite when threatened or surprised, but most will usually avoid an encounter if possible and only bite as a last resort. Snakes found in and near water are frequently mistaken as being poisonous. Most species of snake are harmless and many bites will not be life-threatening, but unless you are absolutely sure that you know the species, treat it seriously.

Snake Bite: Do's

• DO keep the victim calm and reassure the victim that the snake bite can be effectively treated at the Hospital. Call for medical assistance immediately.
• DO keep the affected area below heart level to reduce the flow of venom
• DO remove any rings or constricting items because the affected area may swell.
• DO create a loose splint to help restrict movement of the area.
• DO wash the bite with soap and water.
• DO monitor the person's vital signs - temperature, pulse, rate of breathing and blood pressure if possible. If there are signs of shock (such as paleness), lay the victim flat, raise the feet about a foot, and cover the victim with a blanket.
  

Snake Bites: Don'ts

• DO NOT allow the victim to panic.
• DO NOT let the victim move around or engage in any activity.
• DO NOT raise the site of the bite above the level of the victim's heart.
• DO NOT apply ice or a cold compress on the bite.
• DO NOT apply a tourniquet.
• DO NOT cut into a bite with a knife or a blade.
• DO NOT try to suction the venom by mouth.
• DO NOT give the victim anything by mouth.