Bites of poisonous snakes

Bites of poisonous snakes

Etiology – bites of sea snakes, asps (Central Asian cobra), pit snakes (Asian, eastern and rocky muzzle), vipers (gyurza, sand efa, common viper, steppe viper, Radde viper, Caucasian viper, nosed viper).

Clinical picture

    • cobra bite
    • In the first minutes after the bite – numbness and pain in the bite area, quickly spreading to the entire affected limb, and then to the trunk
    • In the first 15-20 minutes – collapse, then after 2-3 hours blood pressure normalizes, but later, with a weakening of the heart, shock and pulmonary edema may develop.
    • Movement disorders – unsteady gait, ascending paralysis of the motor muscles, dysfunction of the tongue, pharyngeal muscles, oculomotor muscles (aphonia, dysphagia, diplopia, etc.)
    • Respiratory depression can cause death of the victim
    • Arrhythmia, decreased systolic and minute volumes
    • Possible increase in body temperature up to 38-39 ° C
    • The most difficult and dangerous period is the first 12-18 hours of intoxication.
    • Viper and muzzle bites
    • Petechial and spotted hemorrhages in the bite area
    • Rapidly progressive hemorrhagic edema of the soft tissues of the affected limb
    • In the first 20-40 minutes – shock: pallor of the skin, dizziness, nausea, vomiting, weak and frequent pulse, decreased blood pressure, loss of consciousness
    • In severe cases – signs of acute insufficiency of parenchymal organs
    • In the affected part of the body against the background of cyanosis, hemorrhage, hemorrhagic blisters, tissue necrosis, gangrene may occur.
    • The symptoms are most pronounced by the end of the first day of intoxication.

Treatment:

    • First aid
    • Complete rest in a horizontal position
    • Plentiful drink
    • Opening wounds with pressure and vigorous suction of the contents of the wounds by mouth for 15 minutes (not dangerous for the person providing first aid), after which the wound is disinfected and a sterile bandage is applied to it, which is weakened as edema develops
    • Immobilization of the affected body part with splints
    • Contraindications
    • cuts
    • Moxibustion
    • tourniquet application
    • Introduction to the Oxidizer Bite Area
    • Alcohol intake.
    • After providing first aid, the victim will need to be delivered as soon as possible on a stretcher to the nearest medical facility.
    • Specific therapy: mono- and polyvalent antidote sera – antigyurza, antiefa, anticobra, anti-ticobra + antigyurza. Serums are administered according to Bezredka, and then fractionally or intravenously in drops of 40-80 ml (total dose – 1,000-3,000 AU). In case of poisoning of moderate severity, the serum is administered intramuscularly or s / c. With a mild degree of intoxication and bites of low-dangerous snakes (common and steppe vipers, muzzles of the domestic fauna), there will be no need for specific therapy.
    • Anti-shock measures: intravenous solutions of albumin (5-10%), rheopolyglucin, native or fresh frozen plasma (up to 1,000-2,000 ml), transfusion of erythrocyte mass, washed erythrocytes, fresh citrated blood.
    • For asp bites
    • 300 ml or more of anticobra serum intravenously in combination with prozerin 0.5 mg every 30 minutes intravenously and atropine (0.5 ml each 0.1% solution) s / c.
    • If necessary – mechanical ventilation, antibiotics and tetanus toxoid.

The prognosis is favorable. Fatal outcomes are more often observed with incorrect and untimely first aid. Prevention. In places where there are a lot of snakes, it is not necessary to place children’s institutions, to settle down for the night. Reliable protection against bites – boots, clothing made of thick fabric. Snakes are not aggressive and bite only in self-defense, so they should not be caught, played with, kept in living corners of schools. See also Shock ICD T63.0 Toxic effect of snake venom

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