What should I do if I'm bitten by a deadly snake, and it's impossible to get antivenom in time? For example, hopelessly lost in the jungle.

Download directly

quora.com

Apr 22, 2018 7:33 AM

Jordan Benjamin

Resident Expert in Snakebite and Envenomations at Remote Medical International

5w ago

I love it when this question comes up, since snakebite medicine is what I do for a living! Pretty much everything that is common knowledge about snakebite first aid is either completely ineffective or potentially dangerous. The only definitive treatment for a serious snake envenomation is the appropriate antivenom, but here is some specific advice on what to do in the field so you can make it to the hospital alive and receive antivenom. I wrote a very long post to answer this question but I am afraid that it may dissuade the casual reader, so I am including the sparknotes version below. You can read the here if you want the detailed version: Jordan Benjamin's answer to What should you do if a snake bites you in the backcountry many hours away from medical care?

—————————————————————————————————————

The Short Version

DO NOT make a tourniquet, DO NOT cut and suck, DO NOT apply the sawyer extractor or other commercial “snakebite kits”, DO NOT electrocute yourself with a stun gun, and do not follow any strange recommendations you receive from other hikers on the trail. No first aid is often less harmful than bad first aid when it comes to snakebites!

1) Carefully walk backwards and find a safe space to sit down nearby before the venom drops your blood pressure and you pass out and hit your head.

2) Remove any rings, watches, bracelets, and anything else that could become a tourniquet if your limb swells up like a balloon.

3) Circle the site of the bite with sharpie and write the time next to it. Mark the edge of the swelling, make a list of your symptoms, and repeat every 30 minutes or so. Always record the time. The photos below demonstrate this:

Circle the site of the bite and mark the time that it occurred…

…Then mark the leading edge of the swelling and repeat the process as the swelling advances up the limb. It is particularly important to record the time that swelling reaches and/or passes the various joints on the affected limb.

4a) If you are positive that you have been bitten by a neurotoxic snake, apply a pressure immobilization bandage as shown in the diagram below, but DO NOT USE THIS FOR VIPER BITES!Once it is on you can't take it off and it will slow your ability to walk out so choose wisely. For a viper bite, this may result in much more extensive tissue damage to the limb and should not be used.

4b) If you begin to experience signs of anaphylaxis (swelling of face, mouth, or throat; hives; difficulty breathing, etc) use an epi-pen if you have one and then take Benadryl and Zantac.If you don't carry these things in the backcountry you should do yourself a favor and get them because you can't macgyver an epi-pen out of nothing. A lot of things can cause anaphylaxis and epi-pens can also be used as a last-ditch intervention for severe asthma attacks.

For more information about how to treat anaphylaxis in the backcountry see my blog post on the subject here: How to treat severe allergic reactions and anaphylaxis in the backcountry (and a trick to squeeze a few extra doses out of your epi-pen) by Jordan Benjamin on Snakebite and Wilderness Medicine

5) If you have cell phone reception call 911*, tell them where you are, when you were bitten, and the list of current symptoms you just wrote down.

*If you aren’t in the United States, look up the local emergency services number (whatever the equivalent of 911 is) and add it to your phone before you head out.

6) If you don't have reception, plot the safest and most expedient path to find it or reach a vehicle (whatever is safer/faster) and then start hiking out.

Time is tissue and it may be better to walk yourself out in an hour than to sit on your butt for 5 hours until a helicopter can show up. I think the idea that one should do everything possible to avoid speeding up circulation of venom is bad advice. You are already terrified from being bitten by a snake so your heart rate and blood pressure are already sky high. I've treated lots of bites in remote places and pretty much all of them had to hike out to reach the hospital. Figure out the fastest, safest route to find help and then make it happen.

Once again, for the long version of how to survive a snakebite in the backcountry go to this post:Jordan Benjamin's answer to What should you do if a snake bites you in the backcountry many hours away from medical care?

This is a Sawyer Extractor, and you should never use it for a snakebite! If you want to learn more about why you shouldn’t use it, read the longer post linked to earlier or check out the more specific answer below: Jordan Benjamin's answer to What is the Quora consensus on snake bite kits? I've heard arguments on both sides.

Palyne Gaenir

5w ago

I knew a man this happened to. He was backpacking from NY to CA back in the 60s and he was bitten on the back of the thigh so he could do nothing about it. He expected to die and he lay right where he fell, face down, and relaxed himself to talk to God and prepare to die. And 8 hours later he realized he was still lying there. Later, doctors theorized that because he was very healthy and because his heart had been fairly calm and he hadn’t moved around… well they weren’t totally sure of how it had saved him but they felt somehow that behavior had. He continued lying there — he peed in place — and the next morning, slowly and carefully, he got up, went to the nearby stream for a bath, and was able to gently move on. I do not think this is common or a likely outcome for most people or situations, I mention it only to point out that not everybody bitten by a venomous snake dies.

Tiberiu Tesileanu

works at Institute for Advanced Study

6w ago

At least according to Dr. Struan Sutherland, as quoted by Douglas Adams in “Last Chance To See”,

"So what do we do if we get bitten by something deadly, then?" I asked.

He blinked at me as if I were stupid.

"Well what do you think you do?" he said. "You die of course. That's what deadly means."

PS: OK, perhaps you should follow other people’s advice on this page…

Wilderness Master

Founder/Chief Editor/Wilderness Master at WildernessMaster.com (2016-present)

10w ago

Well, first off, if you are hopelessly lost in the “jungle” then you have a much bigger problem than the snake bite and are probably going to die - not from the snakebite. Jungles are nasty, nasty places and tend to “eat” people who get lost in them.

That said, the current priorities will be:

1. Dealing with the snake bite.
2. Calming the person and refocusing.
3. Identify a survival plan.

It is important to identify the snake. I have personally handled and been around a lot of snakes and I have been bitten. I was once bitten by one and the bite looked exactly like a poisonous bite (fang marks vs. teeth marks). Given I was bitten, I made the immediate decision to catch the snake for proper verification (NOTE: it ended up being a black racer, but initially looked more like a moccasin). That saved me from a lot of harsh medical treatment.

Even if you are bitten by a “deadly snake”, you need to remember a few things. First, all “deadly” in any snake (or disease) is a percentage. Granted it is a high percentage, but a percentage. That means there is a percentage that you will survive. You also need to remember that some people by hook or crook also have some immunity. I remember talking to a herpetologist about snake bites when we were training the British SAS and he said that his experience is that most people have some level of resistance to most venom (analogous experience not laboratory).

Finally and this is THE MOST IMPORTANT… Snakes have to “charge” their fangs. MOSThuman snake bites are “fear bites” that do not allow the snake to properly charge their fangs. That means you probably haven’t received a “dose” of venom, or you have received far less than a lethal dose of venom - since most snakes try to avoid humans at all cost!

Treatment:

Remain calm above all things. If you are going to die, it is probably being lost in the jungle that is going to kill you. Spend a small amount of energy (since you are in a jungle) getting yourself off of the ground because the next 24–72 hour is going to be a bitch if you did get a dose of venom. You need a safe place to basically “crash” and the jungle floor is an unsafe place to crash (typically). If you are in other environments, spend the least amount of energy to create a crash pad. You will need at least 24 hours of crashing safely to determine whether you have received a dose of venom and then be able to deal with the initial effects. Somewhere around the 48 - 72 hour period you will have to make a critical decision about “cutting bait and running” (moving).

Please, please since you may be incapacitated put out any survival panels or bright colored items, Generally, make yourself and your location as NOTICEABLE as you can. This may be the thing that saves your life. Equally so, make the decision to set up your crash pad somewhere you could be found (like a path, near the water if safe, etc).

Since you are in the jungle, your venom can be almost any type. While there are technically 4 chemical components that cause the poisoning in snake venom, the effects can be broken into three broad categories:

• neurological
• cardiovascular
• cell/tissue destruction

This list is actually in the order of most lethal effects to least lethal effects. If you are bitten by a lethal dose of poison that is either neurological or cardiovascular and your body is going to succumb - it will probably be in the first 24 hours. The last category can go on for days and is the one that around the 24–72 hour mark you have to decide “what next to do”.

The reality between your ultimate treatment in the jungle or in a hospital is very slim. The ONLYthings a hospital can or will do differently than your own ability to treat is:

• supportive therapy - fluids, food, antibiotics
• emergent therapy - cardio-version if your heart stops, etc.
• ASV - anti snake venom. This is actually what most people think is going to save their life, but is almost as risky as the actual snake bite and is not given as quickly or freely as the general public imagines.

Your treatment of yourself should include:

• Relax and remain calm.
• Get yourself in a resting position, but lower the bitten area below the heart.
• Hydrate, snack lightly (don’t overdo on it since you could vomit during the reaction to the venom).
• Clean and dress any wounds.
• Take any good mental time you have (before the venom make take over) to “fix” in your head your plan. You need to be able to go with this plan once you get to the PONR (point of no return). The plan needs to be the quickest way to get un-lost and found!

Do not:

• Incise the marks and suck or try to suck them. Especially in the jungle - this could become your death from secondary infection or attracting predators (or insects) who may want to eat you.
• Put on a tourniquet or try to restrict blood flow. This will put you in a bad ju ju scenario under some envenomation scenarios.

Here is the truth, a tough one but survival is a bitch…

Between the 0 - 24 hour mark one of three things will happen:

1. You die from neuro-toxic or cardio-toxic symptoms.
2. You have mild to minimal symptoms and they pass (you probably got little to no venom).
3. You suffer symptoms and the most critical ones pass and you enter phase 2 of the symptoms.

If (2) or (3) happens, and you find your way out of the jungle, buy a freakin’ lottery ticket.

If you find yourself to be that lottery ticket candidate buyer, then somewhere between 24–72 hours you need to execute your “plan” and get found. Understand that, unless you are really lucky and the symptoms were super mild, you are going to be doing so feeling pretty weak, still sick and probably suffering some creeping necrosis. What is necrosis? That means skin, muscles, maybe even organs can be dying off. So, your plan has to be very svelte and easy on you - or the jungle WILL KILL YOU!

Finally… GOOD-FREAKING-LUCK if you ever find yourself in this situation. It is a tough one.

For more nuggets of wisdom like this you can look at our information portals at:

Dennis Mulgannon

Vietnam Era, Special Forces (3rd MSF, 5th SFGA)

12w ago

EDIT: Please do not pay any attention to anyone who says that you are automatically dead, when bitten by a snake. It is true that you may die, but that is true of any event which results with an injury. Keep your wits about you, and do whatever you can to remain calm. Also, the jungle is not a treacherous environment to those who take the time to gain experience.

You are more likely to be bitten by a snake while out hiking in the USA than you are out in the jungle. Shoot, in Hemet, CA and Palm Springs, CA your more likely to be bitten while changing the filter for your swimming pool.

Your first defense is to be aware of your surroundings, as snakes have no interest in biting you unless you pose a threat. Reaching under rocks and into holes in the ground, or surprising them while hiking through tall grass is enough for a snake to take a defensive posture against you.

Your next defense when in the wilderness is to never travel alone.

Wear tall boots, and carry a proper hunting knife, and have a good walking stick. If you come across a snake unexpectedly, you can use the stick to fling it away if you don’t think you have time to back away. While I have never been bitten, I have flung a couple and had to kill one. Just be careful not to fling it at anyone who might be in the area.

In the Army—1968—we were taught to remain as calm as possible, to sit upright and wait it out if we were unable to contact help. It is a good idea to kill the snake as well. Panic and shock can kill a person faster than snake venom. This is also true of other injuries, as people having minor, but gory looking injuries have died of shock, yet they would have survived had they remained calm.

In the Army, our instructor had experienced snake bite and lived. He said that it was extremely painful, and he became violently ill, but lived to teach us about the experience.

As a Boy Scout, we were taught to cut the wound with an X, then suck out the blood and the venom. A bit later it was taught to cut lines parallel to the bite marks. and apply a tourniquet. Now, it is taught not to restrict the flow in any manner because the venom when permitted to concentrate in an area, due to restriction, will destroy flesh and tissue. Therefore rings, bracelets, watches should all be removed.

In this modern world, you may be able to use your cell phone to call for help, provided you are in a service area. With modern GPS devices, a responsible hiker should have no excuse for not knowing where they are.

Again, when travelling out in the bush, you should always have a buddy with you, so that one of you can run for help, if need be. If you are a beginner, take it easy. Mark your trails, carry plenty of water, and wear good boots and long pants. Oh, yeah! When you camp overnight, be sure to shake your boots out in the morning before you put them on. Before putting them on is key.

Once you become a wilderness expert, you can push your envelope a bit more.

Don’t listen to people who say that you are dead if you are bitten. If you believe that, you surely will succumb to the effects of shock. Keep your wits about you. And, if you are going to be out in the boonies, read about the kind of critters that you may cross paths with. In the USA, any BLM office will help you. After all, the BLM is there not only to preserve natural habitats, they are there to help you enjoy your experience out in the sticks.

Derek Mathias

Evolution degree, decades arguing with Christian apologists.

8w ago

Carry a stun gun and you should be good to go. Or you can use pretty much any internal combustion engine. A pulsating DC current of 25,000+ volts at 1 milliamp applied three times to a bite, for half a second each time, should rearrange the poison enzymes and neutralize them. Any stun gun or IC motor should work. If you’re using a motor, pull one of the spark plug caps and stuff one end of an electrical wire into it, and use the other end to shock the bite. Stun gun or motor, you should have a grounding wire or plate on the other side from the snake bite.

This technique has been used successfully on rattlesnake and bushmaster bites, as well as fire ant and scorpion stings. I personally used the technique (using a VW bug engine and a couple pieces of wire) to neutralize the venom of a Portuguese man-o-war that had wrapped around a woman’s arm while we were out in the boonies, and I also used it to successfully eliminate the swelling of someone’s allergic reaction to sand flea bites.

The shocks aren’t pleasant, but it sure beats the alternative.

BTW, I learned about this technique from a Dr. Guderian at the Vosandes Hospital in Quito, Ecuador after reading about his work on the subject in a magazine and realizing he was in the same city where I happened to be living at the time.

John Stevenson

Dog Tragic, and Cycling Journalist

6w ago

You, or better still someone else in the party should apply pressure-immobilisation techniquebandaging.

Most of the answers that have been supplied are absolute crap. Sorry, that’s not very BNBR, but giving bad advice about survival first aid is just a shitty and useless thing to do. If you don’t know what you’re talking about, grab a big frosty cup of STFU.

Gianni Mariani’s 11-point plan is spot on. I’ll pick up a couple of his points and explain why they’re the right thing to do.

[Edited to add:] Jordan Benjamin’s answer is excellent too. Go read it.

I lived in Australia for 14 years, and one of the first things I did when I moved there was take a wilderness first aid course. I was spending a lot of time mountain biking in the bush, so I figured knowing what to do in the event of a snakebite might just be useful one day.

I’m happy to say I never needed the first aid knowledge, but I did learn some very useful things about venomous snakes. I carried enough bandages in my Camelbak to do pressure-immobilisation in case I ever needed it though.

So, snakes.

1 Leave them alone. You’re far too big to eat so the only reason a snake will try and bite you is if it feels threatened. Don’t try and kill or catch it and it’ll go about its way. I encountered lots of brown snakes in the time I lived there, a couple of red-bellied black snakes as well as non-venomous snakes like carpet pythons (which can still give you a painful bite) and a green tree snake, one of the prettiest animals I’ve ever seen. I never felt in any danger of being bitten.

2 Snake identification is hard. Even experts struggle to tell one species from another by appearance alone. Just as dogs come in lots of colours, so do many species of snake. So even if you think a snake is harmless, leave it alone.

3 Venom travels through the lymph system. This is a network of ducts in the body that drains tissue fluid back toward the heart. It’s separate from the blood circulation and as such is not pumped by the heart. Rather the lymphatic system has valves so the flow only travels in one direction, and the compression of the lymphatic vessels comes from the movement of muscles.

This is why it’s pointless to cut the wound, try and suck out the venom or apply a tourniquet. The venom is in the muscle tissue under the wound. You physically can’t suck or cut it out, and because it’s not in the blood stream there’s no point trying to stop the blood flow. There are almost no common situations where a tourniquet is indicated anyway; stopping blood flow is a good way to kill a limb.

Pressure-immobilisation technique involves bandaging the affected limb from the extremity toward the armpit or hip, wrapping the bandage firmly to compress the lymphatic vessels. This is combined with splinting the limb with whatever you have to hand or can find: walking poles, branches, fence posts etc.

The idea is to stop lymph flow by compressing the muscles and also to stop the movement of the muscles, because that movement could still force some fluid through the lymphatic system.

In a perfect world you’re in a party of three or more so that a first-aider can stay with the patient and keep him/her calm, reassured and comfortable, and one or more can go for help.

The advice not to wash the bite area is so that when proper medical attention is available a swab can be taken of the venom, the snake species identified, and the proper antivenin administered.

TL;DR: leave snakes alone, carry bandages, know how to do pressure-immobilisation technique.

Original siteon Quora

Report a problem

COPY SUCCESS