Snakes

[Motard660]

Drango's.....

 

I like your comment and find it interesting to read. I got to the conclusion that you know about snakes act act act.....

 

My biggest question...

If, and I say IF with the highest of respect...a person do get bitten by example a green / black mamba, how much time to do an average person have available to get medical assistance. (that is now before it is to late)

 

The reason why I ask...from time to time you will be nowhere close to a road, or a landing place for a helicopter (plantations) and medical personnel need to navigated to where the incident occurred, and take into consideration you deal with the New South Africa act act...and that all take valuable time in a situation like this.

 

I know it will differ from types of snakes, but because I mostly ride in Mamba area, I am mostly concern about them!!

 

On the other hand, I can not remember hearing from any fatalities where a Mamba was involved in last couple of years....but still be interesting to know.

[montyzuma]

Sorry Drongo, I must disagree strongly with some of your assertions.

 

While I agree that over 95% of snakebites will not be fatal, they are by no means uncommon, with an incidence of 30-80 hospital admissions per 100,000 population per annum in SA.

Note admissions - many more don't present to hospital, many are not admitted and a number die before making it to hospital.

 

You do not have hours with Mamba envenomations. You may have minutes, especially where your circulation is rapid as in cycling. I quote the example of Colin van Heerden who was bitten during the 2002 Dusi marathon, and was incapacitated within minutes.

 

Pressure bandaging is ineffective for Mamba envenomations - the venom is too rapidly absorbed.

Pressure bandaging has not been shown to be effective for South African snakebites, except possibly for non-spitting cobra bites where venom is transported via lymphatics. Most of the research on pressure dressings was done in Australia, where venoms are different to SA. However Australian research has shown that correct application of a pressure bandage is the exception rather than the norm, even in trained individuals.

 

A tourniquet is ABSOLUTELY contraindicated in cytotoxic envenomations.

 

A tourniqet can be left on for 90 minutes without risk of tissue ischaemia. It should not be released every 30 minutes as that would defeat the object of the exercise and allow circulation of venom to the rest of the body. We are talking about an arterial tourniquet here - it must be tight enough to stop circulation into the limb (ie no pulse palpable). Use a broad belt or strap from a Camelbak etc.

 

 

 

.

[tubed]

Interesting thread - thanks for the informative contributions.

I met this biggish puff adder on the the Silvermine track as it begins to drop down to Tokai after the boom.

 

It was very sluggish as it tried to climb up a small embankment and didn't succeed after a number of attempts to get up the bank so eventually just lay there, possibly it had eaten recently as it was quite thick in the middle third of its length.

 

Just some other trivial but interesting points somewhat related to the discussion on dealing with snakebites, (although one would have to fall on this chap to get him to bite you).

 

- this is third large puff adder I have seen on this route in in the last 4 months, all were actively crossing the path, but in most cases I think people would have ridden past them without noticing them, or being aware of their markings

- I didnt see another mountain biker at all yesterday on the mountain (I waited for 10 mins while taking pics of the puffy, hoping to show him to somebody else - but nobody passed), that is up the Wapad from Noordhoek or down into Tokai and through the singletracks to exit at Tokai, it was between 2 - 3 pm, which is highly unusual and given that in large parts of this ride the cell reception is poor or non-existent it is quite interesting given the rest of the discussion here about help from a fellow cyclist or outside help, (it would be quite a sequence of events for this to happen, but it could be the case.)

- the lack of people on the trail resulted in a largish grysbok darting out in front of me and across the track on the Silvermine side, these are usually very shy, mostly nocturnal, so to see one mid afternoon is a real bit of luck

Edited December 30, 2011 by tubed

[johannrissik]

@Montyzuma

Great post(s).

This is probably as important as knowing how to administer CPR correctly and should be common knowledge amongst the mtb crowd.

You're about to publish a short guide for us (but just didn't know that yet)that fits on a laminated card in the hydration pack.

[montyzuma]

Thanks Johann, Swiss, Motard.

 

While there is a small chance of anyone being bitten while riding, I just wanted to place the correct info out there so that the common misconceptions are rebutted, and provide a simple approach for the average person to remember when faced with a snakebite situation. The most common misconcetion is tourniquet use.

I've seen far too many instances of it's inappropriate use, and the fact that this thread has devolved into a discussion on tourniquet use shows again that the topic is not understood.

 

 

To simplify things to the extreme:

 

 

The vast majority of snake bites in SA are cytotoxic (>90%)

-Pressure immobilisation should not be used in cytotoxic envenomation

-Tourniquets absolutely contraindicated in cytotoxic envenomation

It follows that if the snake is not positively identified then pressure immobilisation or tourniquets should not be routinely used

 

Neurotoxic venom paralysis may require ventilation by whatever means are available, from mouth to mouth breathing to

bag-valve mask ventilation to intubation

-This is life-saving and may need to be performed for a prolonged period until the patient reaches definitive care.

 

Spitting cobras and rinkhals can accurately spray venom into the eyes

-Venom washout with water or any available bland liquid is the most effective treatment

 

That is it in a nutshell

 

 

 

.

Edited December 30, 2011 by montyzuma

[johannrissik]

Thanks Johann, Swiss, Motard.

 

While there is a small chance of anyone being bitten while riding, I just wanted to place the correct info out there so that the common misconceptions are rebutted, and provide a simple approach for the average person to remember when faced with a snakebite situation. The most common misconcetion is tourniquet use.

I've seen far too many instances of it's inappropriate use, and the fact that this thread has devolved into a discussion on tourniquet use shows again that the topic is not understood.

 

 

To simplify things to the extreme:

 

 

The vast majority of snake bites in SA arecytotoxic (>90%)

-Pressure immobilisation should not be used in cytotoxic envenomation

-Tourniquets absolutely contraindicated in cytotoxic envenomation

It follows that if the snake is not positively identified then pressure immobilisation or tourniquets should not be routinely used

 

Neurotoxic venom paralysis may require ventilation by whatever means are available, from mouth to mouth breathing to bag-valve mask ventilation to intubation

-This is life-saving and may need to be performed for a prolonged period until the patient reaches definitive care.

Spitting cobras and rinkhals can accurately spray venom into the eyes

-Venom washout with water or any available bland liquid is the most effective treatment

 

That is it in a nutshell

 

 

 

.

 

I'll be engraving this on my stem so it will be abbreviated to:

 

HTFU CTFD CPR > MEDIC

[The Drongo]

Sorry Drongo, I must disagree strongly with some of your assertions.

 

While I agree that over 95% of snakebites will not be fatal, they are by no means uncommon, with an incidence of 30-80 hospital admissions per 100,000 population per annum in SA.

Note admissions - many more don't present to hospital, many are not admitted and a number die before making it to hospital.

 

You do not have hours with Mamba envenomations. You may have minutes, especially where your circulation is rapid as in cycling. I quote the example of Colin van Heerden who was bitten during the 2002 Dusi marathon, and was incapacitated within minutes.

 

Pressure bandaging is ineffective for Mamba envenomations - the venom is too rapidly absorbed.

Pressure bandaging has not been shown to be effective for South African snakebites, except possibly for non-spitting cobra bites where venom is transported via lymphatics. Most of the research on pressure dressings was done in Australia, where venoms are different to SA. However Australian research has shown that correct application of a pressure bandage is the exception rather than the norm, even in trained individuals.

 

A tourniquet is ABSOLUTELY contraindicated in cytotoxic envenomations.

 

A tourniqet can be left on for 90 minutes without risk of tissue ischaemia. It should not be released every 30 minutes as that would defeat the object of the exercise and allow circulation of venom to the rest of the body. We are talking about an arterial tourniquet here - it must be tight enough to stop circulation into the limb (ie no pulse palpable). Use a broad belt or strap from a Camelbak etc.

 

 

 

.

 

No worries chap. Not looking to fight, or disagree. We are looking to give people the right advice.

 

Besides having said, possibly mistakenly, that you have hours to spare with a mamba bite, I have pretty much said what you have i.t.o pressure vs tourniquet vs getting medical help fast.

 

In terms of Hubbers interests,if there are specific assertions with which you disagree, please state what they are by quoting and correcting. Thanks.

 

As previously stated, I side with advice given from qualified medical practitioners who are experienced in this field. As it is unstated, we are not sure of your qualifications as yet.

As I stated, my own experience holds no qualification other than personal interest, and experience.

 

Again, as stated, individuals will react in different ways to envenomation. Friends I know who have been bitten a number of times by highly venomous snakes have to be careful of hypersensitivity. The only recorded death of an individual bitten by a Berg Adder was put down to death induced by shock, and not the bite itself.

 

In terms of my own experience I have been bitten twice by Rhombic Night Adder, once by Natal Black snake (no apparent envenomation) and once by Mole Snake (non venomous) but still damn sore.

 

Whilst working on the Inanda dam project I encountered many Black Mamba, but fortunately never had a close shave. Two workers did die after being bitten by Mamba however.

The first, bitten whilst in the enclosed cab of large plant died of cardiac arrest due to shock - 15 minutes by eyewitness account - (as per the coroner report and inquest)and not as a result of actual venom.

The second died, a day after being bitten, as a result of not reporting the bite, or reporting for first aid. The reasons for him doing neither remained unclear at time of inquest.

 

Yes. Snake bite is common. Fatality not so.

 

As in any medical emergency, if you are unclear about what first aid to administer, it is best not to.

Get medical help as soon as possible.

Treat all bites as serious.

[leet22]

No worries chap. Not looking to fight, or disagree. We are looking to give people the right advice.

 

Besides having said, possibly mistakenly, that you have hours to spare with a mamba bite, I have pretty much said what you have i.t.o pressure vs tourniquet vs getting medical help fast.

 

In terms of Hubbers interests,if there are specific assertions with which you disagree, please state what they are by quoting and correcting. Thanks.

 

As previously stated, I side with advice given from qualified medical practitioners who are experienced in this field. As it is unstated, we are not sure of your qualifications as yet.

As I stated, my own experience holds no qualification other than personal interest, and experience.

 

Again, as stated, individuals will react in different ways to envenomation. Friends I know who have been bitten a number of times by highly venomous snakes have to be careful of hypersensitivity. The only recorded death of an individual bitten by a Berg Adder was put down to death induced by shock, and not the bite itself.

 

In terms of my own experience I have been bitten twice by Rhombic Night Adder, once by Natal Black snake (no apparent envenomation) and once by Mole Snake (non venomous) but still damn sore.

 

Whilst working on the Inanda dam project I encountered many Black Mamba, but fortunately never had a close shave. Two workers did die after being bitten by Mamba however.

The first, bitten whilst in the enclosed cab of large plant died of cardiac arrest due to shock - 15 minutes by eyewitness account - (as per the coroner report and inquest)and not as a result of actual venom.

The second died, a day after being bitten, as a result of not reporting the bite, or reporting for first aid. The reasons for him doing neither remained unclear at time of inquest.

 

Yes. Snake bite is common. Fatality not so.

 

As in any medical emergency, if you are unclear about what first aid to administer, it is best not to.

Get medical help as soon as possible.

Treat all bites as serious.

When i worked at Malelane I had to remove snakes almost everyday from hotel rooms from the moz cobra to black mamba's. Even causght a mamab by hand. Was in a cuboard and in the dark and following what a manager told me it was a brown house snake. Well it was till i picked it up and it opened it's mouth. Was the only snake we killed in 3 years there. I even had a pet rock python in all that time only one guard got spat in the eyes and another stood on a scorpion .

Worse bite I had was from a blue headed agama . After i read up on int it says inflicts a painful bite if provocked

[montyzuma]

How do I do the green "XYZ on 29th Dec at 00h00 said" box?

 

 

.

Edited December 30, 2011 by montyzuma

[montyzuma]

Hey Drongo, not looking for a fight either.

 

I just want to get simple, clear info into the Hub public domain so people are not confused by conflicting info. (I am in the medical field).

 

 

 

My specific disagreements:

 

1. "A victim has a good few hours, even in the event of mamba or cobra bites, before death is inevitable, so again, stay calm."

 

- I've dealt with the time-frame for mamba envenomations

 

 

2. Neurotoxic venom[/b] ....pressure applied to the wound, as well as a pressure bandage will help slow the onset of the life threatening symptoms.

 

- Research in SA does not support this - don't waste valuable time applying pressure immobilisation (except possibly for non-spitting cobra bites)

 

 

3. Cytotoxic venom[/b] ....This is where a tourniquet can be life saving. Monitor swelling (caused by the constriction of the body part) and release for 5 seconds or so every 30 minutes max. Prolonged use of a tourniquet can cause severe tissue damage on its own.[/i]

 

- Perhaps you meant Neurotoxic venom, but a tourniquet is absolutely contraindicated for cytotoxic envenomation.

 

Cheers

Montyzuma

 

 

 

.

Edited December 30, 2011 by montyzuma

[The Drongo]

Hey Drongo, not looking for a fight either.

 

I just want to get simple, clear info into the Hub public domain so people are not confused by conflicting info. (I am in the medical field).

 

 

 

My specific disagreements:

 

1. "A victim has a good few hours, even in the event of mamba or cobra bites, before death is inevitable, so again, stay calm."

 

- I've dealt with the time-frame for mamba envenomations

 

 

2. Neurotoxic venom[/b] ....pressure applied to the wound, as well as a pressure bandage will help slow the onset of the life threatening symptoms.

 

- Research in SA does not support this - don't waste valuable time applying pressure immobilisation (except possibly for non-spitting cobra bites)

 

 

3. Cytotoxic venom[/b] ....This is where a tourniquet can be life saving. Monitor swelling (caused by the constriction of the body part) and release for 5 seconds or so every 30 minutes max. Prolonged use of a tourniquet can cause severe tissue damage on its own.[/i]

 

- Perhaps you meant Neurotoxic venom, but a tourniquet is absolutely contraindicated for cytotoxic envenomation.

 

Cheers

Montyzuma

 

 

 

.

 

Thanks for pointing out the error, and discussing the advances in understanding of pressure bandaging. 100% agreed, and I have edited my post.

[The Drongo]

How do I do the green "XYZ on 29th Dec at 00h00 said" box?

 

 

.

 

Click on the REPLY button below right on the post you wish to comment on / edit.

[Pieterg]

Also had a few encounters this week a pofadder and a few others,didn't stop the look

[nathrix]

Busy talking about the Rinkhals he just caught, then something gets his attention at his feet

 

Start watching 8 minutes in...

 

[Kranswurm]

This youngster got my attention.I like his attitude

 

https://www.facebook.com/profile.php?id=100010518913293

[Long Wheel Base]

Busy talking about the Rinkhals he just caught, then something gets his attention at his feet

 

Start watching 8 minutes in...

 

Luckily this isn't your first post. Some guys catch insults for posting for the first time on old threads.....................