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A week or so ago I read a story on social media that really broke my heart, about the passing of the former deputy school head of Gxhabara Primary School after a snake bite. I found it fitting to take this opportunity to educate on snake bites and what to do in the unfortunate event of a snake bite.
It is estimated that venomous snakes kill up to 30 000 people in sub-Saharan Africa each year. However, many deaths go unrecorded, and the real number of deaths may be double the reported figure. Botswana is reported to have 58 different types of snakes, of which 22 are not venomous while 7 can inflict rather painful bites. Nine species are considered potentially deadly.
The signs and symptoms of snake bites vary depending on the type of snake venom. They can be broadly grouped in those that affect nerves and the nervous system, those that affect the blood and those that affect the tissues. Symptoms that are due to the venom affecting nervous system include, tingling around the mouth, drooping of the eyelids, increased salivation, difficulty swallowing, muscle twitching, muscle weakness and eventually stopping breathing due to weakness of muscles of breathing.
When the venom affects the blood there is usually bleeding from the bite site and they may be internal bleeding as well. They may also be some bruises on the skin due to failure of the blood to clot. Other snakes commonly caused more tissue damage, with extensive swelling of the bitten area or limbs. This can lead to the skin in that area dying and in severe cases it can lead to loss of limbs.
In the event that one is bitten by a snake, it is important to provide first aid prior to going to a health facility. It is important to try not to kill the snake as it could inflict further bites. If possible, it’s better to take photos from a safe distance to help with identification of the snake. It is important to keep the limb in a neutral position and to remove any watches or rings before swelling sets in. the bite sight must be washed with soap and water and be covered with a dry dressing. It is important to not attempt to suck the venom, apply a torniquet or slash the bite site to drain the venom. It is also not advisable to take painkillers such as ibuprofen or aspirin since they can increase the risk of bleeding.
After first aid is given, it is important that the victim seeks medical attention immediately. The most important treatment modality in management of severe snake bites is the proper administration of snake venom. It however should be noted that there has been a recent shortage of antivenom globally owing to decreased production by pharmaceutical companies. The production of antivenom is laborious and time consuming. Antivenom is also not very profitable for pharmaceutical companies. This has ultimately led to decreased production of antivenom.
The lack of antivenom should not deter health workers though. They should still be able to provide supportive treatment. It is important to closely monitor the victims for signs of deterioration. In certain instance victims may require to be intubated to help them with breathing particularly when there is evidence of muscle weakness or paralysis. Once victims have been stabilized and deemed safe to transfer it is vital that they be transferred to a high center of care by health care professionals.