I'm posting this in the interests of accuracy and to correct a few misconceptions that are obvious from the posts here. Pezulu's post is generally accurate and his advice is sound, but there are a few additional bits of info that might be of use to the forum. You don't have to identify the snake in order to treat envenomation effectively. Venomous snakebites typically cause three syndromes, and are treated on the symptoms: 1.Pain & swelling 2. Weakness/paralysis 3. Bleeding (There is some syndrome overlap but it is beyond the scope of discussion here) Symptomatic treatment is logical because most bites do not result in envenomation, and snake identification is often inaccurate or the snake is never even seen (many envenomations occur at night) . Symptoms of envenomation will appear within an hour - If symptoms and signs of poisoning have not become apparent within 1 hour, significant envenomation has not occurred. The EXCEPTION to this is bleeding in boomslang bites. 90% of venomous bites in SA cause pain & swelling. They are caused by cytotoxic snakes (adders, vipers, spitting cobras). There will be significant pain and swelling within minutes. Tourniquet use is absolutely CONTRA-INDICATED. There is no massive urgent emergency - you have time to get to a hospital, where treatment may or may not require antivenom. Boomslang bites cause bleeding - typically some hours, even day+ later. Again no massive urgency to get to hospital after bite - you have time. Mamba & Cape Cobra bites are neurotoxic - they cause progressive weakness/paralysis. These are true emergencies with no time to waste to get to a hospital. If you are alone you are in trouble. If you are riding with mates then first-aid principles apply. An arterial tourniquet could be life-saving, but they are very uncomfortable and cannot be left on for more than 90 min. Mouth to mouth breathing will maintin your mate's life if he can't breathe. Cardiac compressions are not required - the patient is just paralysed and can't breathe for himself. You may have to keep breathing for him/her for a PROLONGED period until you can get help. In this situation antivenom would be of help, BUT it needs to be given intravenously, so you need to have all the paraphenalia with you, and be able to get a line up, etc. There is a high incidence of allergic reactions, so you would need to premedicate with IV antihistamine. Antivenom needs to be refrigerated to remain effective, so you wold have to carry it in an ice pack.... Basically it's not practical. The essential message for you as cyclists is: Apply standard first aid principles. Cutting, sucking, heating, freezing, steak tenderiser, etc etc are all BS and make no difference. Use an arterial tourniquet for DEFINITELY identified Mamba & Cape Cobra bites, or with rapid onset of progressive weakness/difficulty breathing or for the particular symptoms of a mamba bite (pins & needles around the mouth, excessive saivation/sweating & metallic taste in mouth). Compression bandaging has not been shown to work in South Africa. (Based on Australian research-different venoms) Mouth to mouth ventilation for paralysis can save a life. Eye envenomation by spitting cobras: wash the eye out with copious quantities of water (ideally), energy drink, or urine if no other alternatives. Go to hospital for assessment of all bites, even if asymptomatic. Although you aren't going to use it, here are a few facts on antivenom to clear up the misconceptions: There are only two antivenoms available in SA: 1. Polyvalent antivenom: for all significantly venomous snakes in SA except Boomslang. It is highly effective when used for the right indications. Venoms used as antigens in the preparation of polyvalent antiserum: puff adder, Gaboon viper, rinkhals, black mamba, green mamba, Jameson's mamba, Cape cobra, forest cobra, Egyptian cobra, Mozambique spitting cobra. So no effect at all for any other species. 2. Boomslang monovalent antivenom, for Boomslang bites only. They are still produced from horse serum. The incidence of anaphylactoid reactions is up to 75% for polyvalent antiserum in South African studies.
