Mamba bite

This section will help you get first aid treatment protocols incase of an envenomation. This includes indigenous and exotic reptiles. Please do not use this forum for photo sharing, etc.

Mamba bite

Postby swazi » Wed Nov 17, 2010 3:12 pm

It’s cold, wet and raining so no call-outs. Thought I would sit down and write (a loooong story to while the time away ) about our weekend.

Some of you may know Dr. David Williams. He was at the snakebite symposium in Kenya and we had planned that he comes to Swaziland to see what our clinics and hospitals look like. David was supposed to arrive on Thursday, but due to unforeseen circumstances only arrived very late on Friday. This meant we only had one day (he was leaving early on Sunday to meet Arno) to see what needed to be seen.

We went up to one of the bigger hospitals where I know some of the doctors quite well. David wanted to chat to them just to get a general idea of the problems we face. As expected, the reception was lukewarm, but we persisted. There was one young girl with a minor bite in the children’s ward and two adults had just been discharged.

As we were leaving I asked if they had any antivenom – the Doctor assured me that they had enough (I supply them with antivenom when and if I have any) stock. David and I checked at the pharmacy and found 5 vials – not too bad.

We drove home, eager for lunch! Before we even reached home, a doctor from said hospital called. Could we please come back, there was a mamba bite victim. David turned the car around and drove (in record time I may add) back up the hill.

This young man was putting his books away into a cardboard box when he felt a small prick on his finger. The snake was small but he recognised it as a black mamba.

He panicked, ran outside, saw a piece of wire and used it as a tourniquet. Just to make sure, he used a shoelace as backup. Now this guy is from a rural area and is as poor as a church mouse. He tried desperately to find a lift to the hospital – begged and pleaded for anyone to help him.

His arm started to hurt, and thinking it’s the effect of the venom, decided the only thing he could do to save himself was cut.... He slashed away with a razor until he thought it was bleeding enough to get rid of the venom.

Finally he found a kind soul, who agreed to drive him to help. He finally arrived at the hospital 4 hours after the bite occurred.

David and I arrived to find him lying on the bed. I don’t want to go into details about the treatment or rather lack of it on a public forum, but if it wasn’t for David, who very diplomatically stepped in to help, the outcome may have been rather poor for this poor young man. The good thing is the doctor who was rather cool during the previous visit, showed a lot of interest and asked a lot of questions about the treatment process.

The young man was definitely bitten by a Black mamba as his symptoms included sweating, gooseflesh, shivers, fasciculation’s (involuntary muscle twitching - quite fascinating to watch really), severe dry mouth, paraesthesiae (pins and needles), bitter taste and was clearly agitated and totally frightened

(Pics by Dr. David Williams)

The bite site was only one tiny fang mark on the finger (bruised area), this probably saved his life. If it was a bigger snake with a proper two fange bite, he would most likely have died long before he could get to a hospital.
Image

The young man lying on the bed in the ER. Notice all the blood on his longs and the sweat stains on his shirt.
Image

The tourniquet/s. I know it is never a good idea to tourniquet but what do you do if there is no way to get to a hospital, nobody knows basic first-aid, you have nothing but a piece of wire and a shoesting, and you have been bitten by the most feared snake in Africa? I would do the same thing - ok not with wire and a shoestring I must admit - but NOBODY must tell me they would just "tata ma chance" and hope they make it to the hospital...which will take 4 hours...
Image

His butchered arm – boy that must have hurt! See how strangely his arm is swollen from the tourniquet and the marks from the wire and shoestring.
Image

There was no time to waste so the antivenom was administered I.V. push.....ice-cold, it couldn’t have felt pleasant at all but he didn’t even seem to notice. He kept on moving his head from side to side, clearly feeling bloody awful.

Image

Anyway, it turned out ok. He is still in hospital but not because of the venom but because of the infection in his arm.
Swazi
Women are Angels...and when someone breaks our wings...we simply continue to fly...on a broomstick..we are flexible like that.
User avatar
swazi
SA Reptiles Member
 
Posts: 1075
Joined: Thu Mar 29, 2007 12:31 pm
Location: Swaziland

Re: Mamba bite

Postby swazi » Wed Nov 17, 2010 3:30 pm

Admin @ what's wrong with the last picture or is it just me?
Swazi
Women are Angels...and when someone breaks our wings...we simply continue to fly...on a broomstick..we are flexible like that.
User avatar
swazi
SA Reptiles Member
 
Posts: 1075
Joined: Thu Mar 29, 2007 12:31 pm
Location: Swaziland

Re: Mamba bite

Postby froot » Wed Nov 17, 2010 3:46 pm

I added the .jpg bit onto the image filename.

Thanks for sharing this Swazi. I think it was quite prudent of him to tourniquet his arm, I would've done the same thing if I was 4 hours away for help. And he identified the snake correctly!
We salute the improvement of the human genome by honoring those who remove themselves from it.
Of necessity, this honor is generally bestowed posthumously. - www.darwinawards.com
User avatar
froot
Founder Member
 
Posts: 6901
Joined: Fri Jul 15, 2005 8:19 am
Location: Joburg, South Africa

Re: Mamba bite

Postby Wolf777 » Wed Nov 17, 2010 4:42 pm

Glad to hear it all turned out well. If I was bitten by a black mamba and didn't have anything else, I think I would've used a shoelace, but not a razor though-must've hurt like hell.
User avatar
Wolf777
SA Reptiles Member
 
Posts: 2342
Joined: Thu Jun 12, 2008 9:07 pm
Location: Giyani,Limpopo

Re: Mamba bite

Postby Scar69 » Wed Nov 17, 2010 4:51 pm

Wow,

Very intresting Story Swazi.

Any idea as to weather or not anyone went to the guy's home to look for the Snake ?
Akshar Sookraj

"Use Your Enemy's Hand To Catch A Snake"
User avatar
Scar69
SA Reptiles Member
 
Posts: 213
Joined: Thu Apr 08, 2010 12:43 pm

Re: Mamba bite

Postby Spider » Wed Nov 17, 2010 5:38 pm

Brilliant story !!! It just shows you how potent their venom is, one little scatch and he's in hospital.
“When spider webs unite, they can tie up a lion”
User avatar
Spider
SA Reptiles Member
 
Posts: 387
Joined: Sat Sep 25, 2010 9:10 pm
Location: Secunda

Re: Mamba bite

Postby swazi » Wed Nov 17, 2010 6:29 pm

Thanks Froot - old age an all you know...

scar69 they did look for it but couldn't find it.

If all there was, was a piece of wire, I would have fought for it! :smt021 Well maybe I would have used my shirt and arrived at the doc naked :shock:
Swazi
Women are Angels...and when someone breaks our wings...we simply continue to fly...on a broomstick..we are flexible like that.
User avatar
swazi
SA Reptiles Member
 
Posts: 1075
Joined: Thu Mar 29, 2007 12:31 pm
Location: Swaziland

Re: Mamba bite

Postby Mr Venom » Wed Nov 17, 2010 7:32 pm

Brilliant story gave me goosebumps luckily it was a juvenile but that doesn't make a difference a mamba is a mamba! :!:
User avatar
Mr Venom
SA Reptiles Member
 
Posts: 634
Joined: Thu Sep 02, 2010 8:34 pm
Location: Roodepoort

Re: Mamba bite

Postby John Rees » Wed Nov 17, 2010 9:45 pm

Gosh judging from your "snake-in-the-bed" story and this one plus how many others you have told, black mambas seem to be REALLY common up your way? The fact that this chap identified it himself perhaps also confirms how common they are? Scary for the locals!
John Rees
SA Reptiles Member
 
Posts: 193
Joined: Tue Apr 14, 2009 4:42 pm
Location: Pietermaritzburg

Re: Mamba bite

Postby Bushviper » Thu Nov 18, 2010 11:14 am

That guy can be very thankful he had an Aussie (PNG transplant) there at the time. I hear it might not have gone so well without his help. How come these foreign doctors keep saving swazi lives and limbs?

That wire will have damaged some tissue and that will also be a cause for concern. Hope his antibiotics clear up the infection.

Thanks for the update Thea.
It is easier to ask for forgiveness than permission.

Those who are afraid to ask are ashamed of learning.
User avatar
Bushviper
Founder Member
 
Posts: 17358
Joined: Fri Jul 15, 2005 10:02 am
Location: Pretoria

Re: Mamba bite

Postby Jen » Thu Nov 18, 2010 7:17 pm

Thanks for sharing, Swazi - another interesting story. You can just see how damn terrified the poor guy was - hacking away trying to remove the 'bad blood'. I'm so pleased that all turned out well for him - I just hope the wounds don't turn too septic. Well done again :)
1.1.0 Epicrates cenchria cenchria
1.1.0 Corallus hortulanus
1.1.0 Heterodon nasicus
1.1.0 Trimeresurus puniceus
2.2.0 Trimeresurus albolabris
User avatar
Jen
SA Reptiles Member
 
Posts: 294
Joined: Sat Dec 26, 2009 6:53 pm
Location: Westville, KZN

Re: Mamba bite

Postby toxinologist » Thu Dec 30, 2010 2:20 pm

I was very happy indeed to be able to make a few little suggestions which, in this case, may have contributed to the happy outcome. I have to say that I thoroughly enjoyed my brief stay with Thea and Clifton, and I am very much looking forward to making the time to do more to help them with improving the treatment of snakebite in Swaziland.
What I would really like to see is some enterprising doctors and scientists in southern Africa who would be willing to look into investigating the use of alternatives to tourniquets and pressure bandages in the first aid treatment of snakebite. Neither are appropriate for dealing with bites by all species of snakes that can cause significant envenoming in the region, and in the case of tourniquets there are some very serious risks and limitations.
Some time ago a study in Myanmar suggested that a modified version of PIB, in which a broad constrictive band (as opposed to a narrow occlusive tourniquet) applied to the upper half of either the leg or arm and combined with immobilisation, could successful limit the development of systemic envenoming after Siamese Russell's viper (Daboia siamensis) bites. Perhaps it is time that an ethically acceptable animal model were used to look at whether this could be suitable after the bites of various African snakes.
The results could deliver a single safe, effective first aid protocol for use after all bites in the region, and would be relatively easy to teach using easily accessible materials.
If anyone is interested please PM or email me.
Cheers

David
Australian Venom Research Unit
University of Melbourne
Parkville Vic 3010 AUSTRALIA

http://www.avru.org
toxinologist
SA Reptiles Member
 
Posts: 48
Joined: Sat Apr 18, 2009 11:53 am
Location: Port Moresby, Papua New Guinea


Return to Venom Club

Who is online

Users browsing this forum: No registered users and 2 guests

cron