snake bite anti venom?
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Utter nonsense, lethal doses from even the Wolds most venomous snakes (including sea snakes, whose venom is the most potent) take an hour to several hours to kill a healthy adult.
With Cobras, Mambas and sea snakes the time from receiving a lethal dose to death as a result is normally measured in hours.
With members of the Viper family (rattlesnakes, pit vipers etc) the time from receiving a lethal dose to death as a result is normally measured in days.
Please check your information against factual sources before perpetuating unhelpful myths by presenting them as advice.
Illumeo please be aware that administering Antivenom is not a simple procedure that can be administered by the untrained, in some circumstances in can be as lethal to the patent as the venom it is being used to counteract (or more so)
Even an experienced medical professional will do everything to avoid administering venom outside of a hospital unless there is no other choice, where the patient is clearly showing multiple indicators of severe envenomation, is becoming progressively worse, is many hours away from medical care and death is certain to result without preventative action.
Under all but the most extreme circumstances outlined above the species specific or polyspecific Antivenom should be administered only by medically trained persons with access to Epinephrine and preferably an antihistamine and hydrocortisone as well for intravenous injection to treat the possible effects of the antivenom.
Download the following text from the Royal Geographical society for detailed information and advice on treating snake envenomation in a remote expedition setting:
http://www.rgs.org/NR/rdonlyres/973A5F00-3FB6-4185-9333-D253D6B0D9F0/0/21ch20.pdf
Thanks Stuart, That is exactly the kind of information I am looking for. Very much appreciated. I will compare that to the company advice and plans. It is the first bit of information that i have seen that gives some idea of how quickly you need to get to a hospital.
Cheers
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I am awaiting an email from my contact at ZSL illumeo and will forward the contents to you via PM when it arrives. Given the fact that they handle both Green and Black Mambas at ZSL, I should imagine the advice will be fairly sound and more importantly species specific 
my pleasure
The Mambas I have personally encountered in the wild (only three of them, in Botswana) have not acted aggressivly, In all cases they where heading away from me as fast as possible, and they move suprisingly fast!
But local people informed me that their behaviour can be very aggressive if you unwittingly approch its nest closely or put it in a position where it feels it has to defend itself from you.
My information comes from Snakes and Snakebite - Venomous Snakes and Management of Snakebite in Southern Africa (1978) by Visser and Chapman. I realise that this is 30 years old now and management practice may have changed, but probably not by much.
Visser and Chapman make the point that adverse reaction to antivenoms is largely associated with the purity of the antivenom and the incidence of exposure to serums in the population.
For the Southern African cobras, rinkhals, and mambas, the above work recommends:
1) Application of tourniquet ASAP where possible to delay venom spread.
2) Immediate venous injection of 10ml SAIMR polyvalent antivenom.
3) Hospitalisation ASAP, whereupon further injection of 30-40ml SAIMR polyvalent antivenom.
4) Respiratory support where necessary.
'Fifteen paces' is, as Stuart suggests, mythology, but the above book states that (black mamba) "collapse within 45 minutes is not unknown". It is interesting to note that there have been cases where people have survived a mamba bite without medical intervention, though the amount of envenomation has not been ascertained. There are also recorded cases where people have died even with prompt hospitalisation (competent and modern facilities) and early use of modern 'effective' antivenom.
Burnt Ash
Visser and Chapman make the point that adverse reaction to antivenoms is largely associated with the purity of the antivenom and the incidence of exposure to serums in the population.
For the Southern African cobras, rinkhals, and mambas, the above work recommends:
1) Application of tourniquet ASAP where possible to delay venom spread.
2) Immediate venous injection of 10ml SAIMR polyvalent antivenom.
3) Hospitalisation ASAP, whereupon further injection of 30-40ml SAIMR polyvalent antivenom.
4) Respiratory support where necessary.
'Fifteen paces' is, as Stuart suggests, mythology, but the above book states that (black mamba) "collapse within 45 minutes is not unknown". It is interesting to note that there have been cases where people have survived a mamba bite without medical intervention, though the amount of envenomation has not been ascertained. There are also recorded cases where people have died even with prompt hospitalisation (competent and modern facilities) and early use of modern 'effective' antivenom.
Burnt Ash
Antivenom has to be given intravenously so there is no point carrying it unless someone knows how to do this. European viper venom antiserum is available, but normally only used if there are systemic symptoms, and deaths from adder bites in the UK are exceptionally rare.
Antivenom for foreign snake bites is held at specialist centres in Oxford Liverpool and London.
Of course, you need to know the species. When I worked in India I saw several agricultural workers with snakebite. There were often conflicting reports of the species involved, so over there polyvalent serum was used that covers several species (krait, russels viper, saw scaled viper etc)
Antivenom for foreign snake bites is held at specialist centres in Oxford Liverpool and London.
Of course, you need to know the species. When I worked in India I saw several agricultural workers with snakebite. There were often conflicting reports of the species involved, so over there polyvalent serum was used that covers several species (krait, russels viper, saw scaled viper etc)
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Burnt Ash, I can tell that your quote is from 30 yrs ago! Without going into specific treatment regimes and triggering a heated debate amongst any clinicians here, I would say the tourniquet is a big no-no (and self-administered IV drugs is also slightly dubious)
The bit about swift hospitalisation and respiratory support is still very relevant (oxygen is always your best drug) (could any doctors please correct me if I'm wrong!)
If you were unsure of the species of snake that had bitten and it wasn't a black mamba, any constriction may retain the venom at the bite-site. If the (unknown) venom caused necrosis (tissue-damage) or gangrene/infection then it would be best spread throughout the body (in effect diluting the venom whilst allowing the body time to metabolise/neutralise/excrete it) rather than retaining it in a localised area around the bite-site.
A tourniquet itself would also cause damage, so if the snake-bite had not resulted in envenomation (ie if the snake did not inject any venom) then you would have caused damage and possible loss of limb for no reason.
The RGS chapter online pdf that Stuart linked to earlier is very good information about all things venomous. I am certainly no expert, but Stuart, I suspect that you are an expedition doctor, do I win £5?!!
The bit about swift hospitalisation and respiratory support is still very relevant (oxygen is always your best drug) (could any doctors please correct me if I'm wrong!)
If you were unsure of the species of snake that had bitten and it wasn't a black mamba, any constriction may retain the venom at the bite-site. If the (unknown) venom caused necrosis (tissue-damage) or gangrene/infection then it would be best spread throughout the body (in effect diluting the venom whilst allowing the body time to metabolise/neutralise/excrete it) rather than retaining it in a localised area around the bite-site.
A tourniquet itself would also cause damage, so if the snake-bite had not resulted in envenomation (ie if the snake did not inject any venom) then you would have caused damage and possible loss of limb for no reason.
The RGS chapter online pdf that Stuart linked to earlier is very good information about all things venomous. I am certainly no expert, but Stuart, I suspect that you are an expedition doctor, do I win £5?!!
What i was told is to not panic as to not get the blood flowing and pump the venom about and if possible sit down while someone goes to get help and squezze around the area of the bite. Came close to a few myself before, laying down next to a sandy bank in the sun and 2ft away is a snake sunbathing in the shallow water( i know now it was a grass snake ) but i stayed as still as a rock thinking in my head what i should do then whever it was the right or wrong thing to do rolled to my other side faster than you could blink and ran about 500 meters.
Just my 2 cents...
Have been (sometimes too) close to several snake species, some known to me (russels viper, cobra's, sea kraits, reticulated pythons, mulga (iirc the official name of a king brown?), file snake, olive python and barba amarilla eeh yellow beard eeh darn what is the english name of it... fer de lance...) and most of them unknown... they all wanted to get away more then attacking me. Protecting themselves they all do eventually... wouldn't you?
Most bites, take a while to take effect like Stuart said, many of them not being venomous at all. But the fear of snakes themselves can cause paralysis, heart attacks etc themselves, let alone being bitten by one, that really plays mind tricks (was about to use different words but this is a family forum isn't it). In my idea that is where the "15 step snake" came from... fear.... and then you drop....out of fear....
As far as I know anti venom needs to be kept in a fridge and then administered properly!
Allergic reactions are pretty common. Most 'natives' I met (wether Thai, Malay, Australian Aborigines, Central American Indians), all put their fate in traditional medicine... I am glad I never had to check their medicinal truth though, and I hold those traditional remedies in high regards!
No tourniqets, cutting or sucking. Proper bandaging, keeping cool, getting pro help asap and more normal first aid....
Grtz Johan
PS Stuart... that was you eating the snake and not the other way around wasn't it ;-)
Have been (sometimes too) close to several snake species, some known to me (russels viper, cobra's, sea kraits, reticulated pythons, mulga (iirc the official name of a king brown?), file snake, olive python and barba amarilla eeh yellow beard eeh darn what is the english name of it... fer de lance...) and most of them unknown... they all wanted to get away more then attacking me. Protecting themselves they all do eventually... wouldn't you?
Most bites, take a while to take effect like Stuart said, many of them not being venomous at all. But the fear of snakes themselves can cause paralysis, heart attacks etc themselves, let alone being bitten by one, that really plays mind tricks (was about to use different words but this is a family forum isn't it). In my idea that is where the "15 step snake" came from... fear.... and then you drop....out of fear....
As far as I know anti venom needs to be kept in a fridge and then administered properly!
Allergic reactions are pretty common. Most 'natives' I met (wether Thai, Malay, Australian Aborigines, Central American Indians), all put their fate in traditional medicine... I am glad I never had to check their medicinal truth though, and I hold those traditional remedies in high regards!
No tourniqets, cutting or sucking. Proper bandaging, keeping cool, getting pro help asap and more normal first aid....
Grtz Johan
PS Stuart... that was you eating the snake and not the other way around wasn't it ;-)
no, not a doctor, sorry.
yes, tasty too, the correct way to deal with large snakes I believe
Well, after a swift search of the internet, there doesn't seem to be much update of the first aid and medical treatments recommended by Visser and Chapman. The former was (is?) one of South Africa's leading herpetologists and the latter was sometime professor of surgery at the University of Natal (Durban).
Tourniquet and compress are still recommended to slow the spread of venom (through the blood and lymphatic systems) where the bite is from one of the potently neurotoxic elapid species (cobras, mambas). A mamba bite is considered to be a desperate medical emergency, requiring aggressive and determined intervention. Risk of limb loss has to be weighed against probable death if intervention is not made. Similarly, I'd risk a stab (pun intended) at self-administered IV injection of antivenom if I found myself bitten by a black mamba. In these circumstances, one really doesn't have the luxury to dick around and observe niceties.
Tourniquets are, of course, completely the wrong thing to do for cytotoxic envenomation (e.g., puff adder).
Burnt Ash
DON'T underestimate the bite of an adder.
A very good friend of mine spent two weeks in hospital after being bitten by a baby adder no bigger than a pencil. He was and still is a perfectly healthy person, and weighs about fifteen stone.
As you quite rightly said an adder bite can kill the very young and ill.
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