a. General
Poisonous snakes are found throughout the temperate and tropical areas
of the world, though the species to be encountered vary greatly on the different
continents. Examples are the rattlesnake of North America, the fer-de-lance of
Central and South America, the viper or adder of Europe, the mamba of Africa, the
cobra of southern Asia, and the tiger snake of Australia. The danger of
suffering a snake bite is greatly overemphasized, since these reptiles usually
will not attack man unless disturbed. Such danger is probably greater in certain
parts of the United States than in any other part of the world, with the possible
exception of India and Burma. Unless one has some knowledge of the habits and
habitat of snakes and is searching for them, they are infrequently encountered
in ordinary travels.
In case of snake bite, it is important to kill the snake and have it
examined, if possible. There are several different types of snake antivenom, and
if the snake is identified it is much easier to select the proper type of
antivenom for the treatment of the bite. The presence of an undigested or partially
digested "ball" of food in the snake's stomach may indicate the amount of venom
injected into the victim when the snake struck. When a venemous snake kills, a part
of the venom is used up; thus, the presence of a visible food ball in the stomach
may mean that the snake's poison sacs were relatively empty at the time
of biting the victim, and therefore that probably only a small amount of venom
was injected.
b. Precautions
(1) Wear boots when walking in snake-infested areas.
(2) When possible, remain on trails.
(3) Avoid the careless touching of shrubs, brush, trees, tree branches, etc., or
walking near ledges where snakes may be hiding.
(4) In some areas, snakes may prefer dark, warm places for rest, and may
crawl into shoes, clothing, or luggage. This is especially characteristic
of the cobra in the Far East. Such articles should be examined carefully
before use.
(5) If bitten by a snake the following procedures are recommended:
(a) Immediately apply pressure or tourniquet (rubber tubing, belt, string, piece
of shirt, vine, or weed) above the bite--no tighter than a snug garter--to
stop return of the venous blood toward the heart. The tourniquet should be
released for a few seconds every 10 to 15 minutes to prevent gangrene.
(b) Under field conditions and in the absence of medical care, do not
make an incision, but instead place a piece of rubber dam three or four inches
square over the site of the fang punctures, and by vigorously sucking and kneading
with the teeth, remove as much venom as possible during a period of 5 minutes. The
rubber dam will prevent sucking the venom into the mouth. Wash the wound and the
rubber dam, and repeat the sucking and kneading at regular intervals, while
removing the patient to the nearest medical officer or other physician.
(c) Kill the snake and take it to the physician for inspection.
(d) Whiskey or other alcoholic drinks should not be given.
(e) As far as possible, keep the patient from exerting himself, for exertion
will increase blood flow and thus cause more venom to be absorbed.
*Prepared in the Office of the Surgeon General.