This is a guest post by Johan Marais of the African Snakebite Institute. ASI is the leading provider of Snake Awareness, First Aid for Snakebite, and Venomous Snake Handling courses in Africa, as well as the largest distributor of quality snake handling equipment in Africa.
With around 175 different snake species in Southern Africa, there is a real danger that one may encounter a snake whilst hiking.
While very few fatal snakebites are recorded in South Africa – around 12 per year – it is important to reduce the risk of a snakebite and to know what to do if someone is bitten.
Nine out of ten serious snakebites in Southern Africa results in cytotoxic symptoms – pain, gradual swelling, blistering, and – in some instances – tissue damage. Most of our fatal bites are from Black Mamba and Cape Cobra envenomation – the venom of these snakes is predominantly neurotoxic, causing progressive weakness that ultimately compromises breathing.
When hiking, stay on footpaths, watch where you are walking, step onto rocks and logs instead of over them, and be careful where you put your hands, either when stopping for a rest or when gripping onto things to climb up or down inclines.
The majority of snakebites are well below the knee and wearing proper snake gaiters will provide good protection against this. Modern snake gaiters are light (around 400 grams a pair), flexible and comfortable, even on long hikes.
Be prepared for emergencies when planning a hike, make sure you have the necessary emergency numbers on your cellphone, and remember that the national emergency number 112 works even if you do not have airtime.
First Aid for Snakebite
As most snakebites are cytotoxic, there is very little one can do other than safely getting the victim to the nearest medical facility. Meeting a private ambulance halfway often makes sense and paramedics are far better equipped to assist bite victims.
Never use a tourniquet to inhibit bloodflow in any way. Dr. David Warrell, World Health Organisation snakebite expert and an Oxford university professor, has the following to say about arterial tourniquets:
Arterial (tight) tourniquets applied at pressures above systolic blood pressure are far too dangerous ever to be recommended as I have made clear in all my publications. If applied at sufficient pressure to the upper arm or thigh where there is no interosseous blood supply they can cause total ischaemia distally with a high risk of gangrene after as little as 30 minutes.
For cytotoxic envenomation, which will include bites from the Puff Adder, Rhombic Night Adder, Bibron’s Stiletto Snake and the Mozambique Spitting Cobra, there is virtually nothing that a first aider can do other than getting the victim to the nearest hospital.
DO NOT cut and try to suck out venom, or put any pressure bandages on. If you are hours away from the nearest help, either send someone to call for medical assistance, or walk back to your vehicle (do not run). Cytotoxic venoms are slow-acting and getting to a hospital within an hour or two will greatly benefit the victim.
For Black Mamba or Cape Cobra bites it is vital to get the victim to a hospital urgently. Victims soon experience pins and needles in the lips, have difficulty in swallowing, sweat profusely, get nauseous and may vomit, experience ptosis and dilated pupils, and eventually battle to breathe.
Be careful of Berg Adders – they are small and bite readily. Their venom is quite unique in that it may cause pain and swelling, cause blurred vision, dilated pupils, affect smell & taste, and eventually affect breathing. Most victims need to be ventilated for a few days but only about 5 – 8 hours after a bite. A Berg Adder bite victim must be taken to hospital urgently, and should not receive any pressure immobilization bandaging.