Tag Archives: snake bite

Thailand Snake Note – Bitten by Snake?

If you are bitten by a snake in Thailand or anywhere in Southeast Asia:

1. Lay down on the ground and be calm. Many bites – around 50% – are “DRY” bites, meaning, there is no venom transferred during the bite.

2. Find someone to help you get to the hospital immediately – don’t wait for symptoms to begin, and don’t drive yourself.

Emergency Numbers:

  • 1155 – Tourist Police – English speaking
  • 191 – Thai police nationwide
  • 1669 – Ambulance nationwide
  • 1646 Bangkok ambulance

3. Stay as still as possible. Tell someone or write down what you can remember about the snake – Color? Thickness? Pattern? Was it in a tree? On ground? Identifying the snake is very important so you get the right antivenin, if one is needed.

4. Rinse the snakebite site with water if someone can bring it to you. Don’t get up to get water, stay laying down. Do not touch the bite site, or massage it, rub it, cut it open, or do anything to the site at all.

IF YOU KNOW WHICH SNAKE BIT YOU:

1. If the snake that bit you is a Pit Viper – any green or brown viper, just rinse the area with water and get to the hospital as soon as you can. Pit viper bites can take many hours and even days to become life-threatening. Pit Viper bites may burn and possibly throb at the bite site. Do NOT wrap a Pit Viper bite.

2. If the snake was a Krait or Coral Snake, you can apply an elastic wrap (or strips of any cloth) to the affected arm or leg, starting at the fingers (toes) and working your way up. Go directly over the bite site. The tension in the wrap should be firm, but a finger should be able to go under the wrap.

Snakes of this type have venom that is primarily neurotoxic, and affects nerve connections. You probably have at least a couple hours before severe effects begin. Wrap the limb and get to a hospital quickly.

3. If the snake was a Cobra, you should not wrap the bite site unless you begin having symptoms of envenomation. Some symptoms are: vomiting, dizziness, severe headache, weakness, slowing of heart rate and/or breathing. Cobras have venom which is both neurotoxic and necrotoxic, meaning it can severely damage tissue at the bite site – especially when wrapped.

If you begin having any serious symptoms soon after a Cobra bite, immediately apply a snug pressure wrap starting at the foot or hand of the bitten limb and moving up the limb. Get to a hospital immediately – having someone take you in a car, truck, or sitting between between two people riding a motorbike. DO NOT DELAY.

IF YOU DO NOT KNOW WHICH SNAKE BIT YOU:

1. If you do NOT KNOW what type of snake it was that bit you, you must wait for symptoms to develop to know what treatment is required. Ideally you will be at a hospital within an hour of being bitten, and they can monitor symptoms. If you have a severe burning or throbbing at the bite site, do not wrap the bite with anything – it is likely to be a Pit Viper or Cobra bite.

2. At the hospital, antivenin is given AFTER you start to have symptoms, not before. Some bites are “dry bites” and inject no venom. 

Caution… antivenin (also called antivenom) can cause severe allergic reaction which sometimes results in anaphylactic shock – a potentially deadly complication. Get good advice on the necessity of antivenin before it is administered. The doctors should do a test to see if you’re allergic to it first before full-scale administration of antivenin.

Insist on it!

Here is how the test for sensitivity to antivenin is administered (from Queen Saovabha Memorial Institute, Bangkok): “Since the antivenin is prepared from horse serum, sensitization to heterologous protein may occur in some individuals. To avoid serious allergic reactions, skin test should be performed prior to the administration by injection of 0.02 ml of 1:100 antivenin dilution intradermally. It should be noted that the skin test may not predict the anaphylaxis nor delay serum sickness reactions.”

Do Not:

  • Suck the poison out or use any devices to suck out the venom, it can cause more damage to tissue if it is a viper bite.
  • Use a tourniquet, electro-shock, or massage
  • Use ice over the wound
  • Drink alcohol, food, or use aspirin or drugs or medicine of any kind.
  • Use herbal remedies – ingested or applied to the bite site.

Sources:

Information for this article was collected from legitimate sources of emergency information regarding snakebite treatment.

If you want to dispute these steps – please send email to: [email protected]

Once you identify the snake that bit you – here is some more information by snake name – scientific classification:

AFPMB – Database of Venomous Animals and Plants (click)

Here is the database listing venomous snakes by country:

AFPMB Database of Snakes by Country (click)

Snake Bite – Red-Necked Keelback – Rhabdophis subminiatus

A couple months back I received an email from a concerned father whose son was bitten by a red-necked keelback (Rhabdophis subminiatus) he had found in their neighbor’s garden.

“My son is suffering from non clotting, severe swelling, and paralysis and is now in ICU, where his vital and neuro signs are ok, but blood not good.”

These snakes have, in the past, not been identified as a dangerous snake. Many people have them as pets, and free-handle them with bare hands. Sometimes these snakes bite, but once they are handled a bit they usually calm down and rarely bite. There have been some cases in the literature where bites have resulted in hospitalization, and there has been a push to identify these snakes as what they are – venomous, and dangerous.

Colubrids, rear-fanged snakes, are nearly all venomous. Venom is modified saliva that helps the snake kill and break down the body of their chosen food.

I was excited to have a response from the father of this boy that spent 2 weeks in a Thailand hospital after suffering 2 bites from this snake.

Here’s what I learned after some questions by email…

1. Can you tell anything about how the bite occurred? Was the snake typically calm – and then, out of the ordinary behavior – it bit your son?

Calm, he was showing off to his friend’s that he can handle snakes, this was a wild one not a pet. He has a constrictor, a corn snake and a python as pets, all fairly placid, but the keelback he had no understanding of.

2. Approximately how long did the snake bite down on your son’s hand? Was it less than 1 second? 1-3 seconds? 3-5? 10? 60 or more? This is the most important question because in the past we haven’t seen enough venom transferred from quick bites, or even repetitive quick bites…

Between 30-40sec I believe, wouldn’t let go

3. Did the snake bite more than once that day?

Bit him twice within a few minutes.

4. Did the snake routinely bite your son – often?

First time.

5. Can you tell me approximately how long was the snake? Do you have any photos of it? Can you please send if you do?

No photo’s I’m afraid, he didn’t mention how long it was, but he will be back from school at the weekend, and I’ll fish more info out of him.

6. Did you get the snake in Thailand? There in Phuket, or where?

Wild snake in his friend’s garden (Phuket).

*******

So, here again – the snake bit down for an extended period of time – 30+ seconds, and had time to squeeze a lot of venom into the boy’s hand.

There is no known antivenin for the Rhabdophis subminiatus as it is here in Thailand. In Japan there is a small amount of antivenin produced for their local species. To my knowledge there has been nobody treated with this antivenin outside of Japan, and I’m sure they would not be all that interested to give up some of their small supply to export to another country.

More information on venom toxicity and treatment after bite by this snake: R. subminiatus.

Venom Characteristics (from http://www.afpmb.org/content/venomous-animals-r#Rhabdophissubminiatus)

Mainly procoagulants, which can cause renal failure; plus mild neurotoxic factors. Envenomation does not always occur. Bite may be almost painless w/ minimal local swelling. Symptoms of envenomation may include local numbness, headache, nausea, & vomiting; in severe cases renal failure has caused human deaths. No known antivenom currently produced.

LD50 for intravenous injection – .125 to .129 mg/kg. That is extremely venomous, in the same category as Bungarus candidus (Malayan Krait), Naja kaouthia (Monocled Cobra), and O. hannah (King Cobra).

One WHO (World Health Organization) publication about the management of venomous snake bites in Southeast Asia mentions the antivenin for Rhabdophis tigrinus in Japan as having some effect on the venom of R. subminiatus. I am not sure if this is strictly for R. subminiatus found in Japan, or not. Worth a try though if you can get them to send you some antivenin. Otherwise, there is no other option – there is no monovalent antivenin specifically for R. subminiatus.

Japan Snake Institute
Nihon Hebizoku Gakujutsu Kenkyujo
3318 Yunoiri Yabuzuka
Yabuzukahonmachi Nittagun Gunmaken 379-2301
Tel 0277 785193 Fax 0277 785520
[email protected]
www.sunfield.ne.jp/~snake-c/
Yamakagashi (Rhabdophis tigrinus) antivenom. Also effective against rednecked keelback (R. subminiatus venom)

I have some time today, and I’m curious what their response will be. I’ll write them to see whether they could, in an emergency, be able to send some antivenin here to Thailand to treat a bite by R. subminiatus or R. tigrinus.

OK, I’ve written them, lets see if they respond…


 

Update 2/11/2016 – No, they did not respond at all. Nothing. Today I was thinking about the topic and decided to write more people to see if I could get some vials of Rhabdophis tigrinus antivenom from Japan to try in treating patients with complications from bites of R. subminiatus. The following is the letter I’m sending to a number of researchers, scientists, and again, to “The Japan Snake Institute.”
Dear Toru Hifumi,

Greetings from Thailand! I am a snake enthusiast from the USA, living in Thailand for the past 11 years.

I read your paper, “Effect of antivenom therapy of Rhabdophis tigrinus (Yamakagashi snake) bites​.”

I have been researching the subject of Rhabdophis envenomation because I have had a few experiences here, helping young (

In two cases the victim was a young male child. One was 12 years old, and the other was only 9 years old. In both cases the boys had kept the snakes as pets and thought them to be harmless.

Both were admitted to hospital intensive care for 10-14 days with bleeding from various orifices and ultimately renal failure.

I have read that your antivenom may help particularly in cases of renal failure.

On two occasions I emailed staff at “The Japan Snake Institute” about possibly purchasing some antivenom to help these boys recover. Unfortunately, I never received any reply from them at all.

I am hoping you will reply favorably after reading this note!

As you know, Thailand has not made antivenom for any snake in the Rhabdophis genus. R. chrysargos and R. nigrocinctus are also found in Thailand, and they may have similarly toxic venom.

I anticipate more emergency situations involving children in the coming year(s) and I must try to help in any way I can.

I am asking you if I can purchase some of the R. tigrinus antivenom for experimental use by hospital staff when patients in Thailand are envenomated by this snake.

We are not seeking to make any profit from this venture, the antivenom will be provided to Thailand hospitals on a case-by-case basis, and at cost (no markup).

As I understand your article to read, each vial of freeze-dried R. tigrinus antivenom, Equine (lot #0001) is able to neutralize the coagulant activity of about 4 mg of R. tigrinus venom.

If we were able to purchase just 10 vials, or even 5, that could be a significant help to patients here in Thailand who need it – especially children.

Would you please respond favorably to this request?

Thank you for your time and concern about what will most certainly be in the near future – a life and death matter.

With highest regards,

Vern J. Lovic
ThailandSnakes.com

Snake Bite! Thai Man Bitten by Monocled Cobra (Naja)

Thai man bitten by a monocled cobra - Naja kaouthia - in Thailand at a snake show
Closeup of cobra bite site on inner right thigh.

I was visiting my friends at the snake show yesterday. One of them was bitten 5 days ago by a Naja kaouthia during one of the shows. It bit his leg through the pants – and got him with both fangs.

Nobody expects this to be a life-threatening bite because he has been bitten 4 times in total now – by the Naja kaouthia (monocled cobra). Humans build up a resistance to the venom over time, and to see the small wound that he has now – it’s hard to believe one of the most deadly snakes in the world bit him.

I’ll attach a video here of me interviewing Dtom and Jackie about how the bite happened – when I get a faster internet connection – right now it’s junk and not working well for a big upload to YouTube.