Stiletto Snake Bite -Atractaspis bibroni

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.

Re: Stiletto Snake Bite -Atractaspis bibroni

Postby vuduman » Mon Dec 06, 2010 11:48 pm

It's very sad.All has been said on here ragarding the treatment.
I have been bitten by Atractaspis bibroni before many years ago.Firstly they gave me a chart to point out the snake that bit me.Then they argued with me about what bit me.My arm swelled a lot,but I've experienced worse swelling before with a nightadder bite that I seeked no medical attention for.

The doctor wanted to perform a fasciotomy after just a few hours "to reliese the preasure" -he claimed.Not once did he even look at the bitemark on my finger.
I didn't know any better,but after a good dose of morphine,I really couldn't care.As long as the unbarable throbbing will stop.

Luckily a specialist came to inspect my arm just in time.He bandaged me up, gave me some antibiotics and painkillers and sent me home the same night.The purples and blue colouration dissapeared after a few days and so did the swelling.
I didn't loose anything.
It just shows that in some cases doctors are too overeager to help without thinking it through.
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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby Nineve » Tue Dec 07, 2010 12:15 am

:shock: :shock: :shock: Nasty!

I am truly speechless. :shock: :shock:

At least they missed the tattoo?! :-?
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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby Graeme » Tue Dec 07, 2010 12:36 am

Thanks a mill, Jen. Now bite victims can make their own choices. I really hope that everyone involved in local venomous snakes gets to read this post, and more specifically your input.
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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby rolandslf » Tue Dec 07, 2010 8:16 am

One word "SHOCKING". Someone overeacted here.
My first look was for a bite site, and then I saw the pic of the bitten finger.
Now I am not much in the way of a medical person, but even I could see that if you look at the bite site, then the bitten hand, and then the arm. The figures when added up just don't balance out.

This poor guy will carry some horrible scars for the rest of his life because of someone elses boob.
It is better to be Pissed Off than Pissed On.
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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby Smeegle » Tue Dec 07, 2010 11:20 am

Looks very nasty indeed! However, since I'm not medically inclined, I asked my brother-in-law what he thinks and he reckons:

Fasciotomies often look terrible but can save limbs. The only way of knowing whether this was appropriate would be to see the arm before the fasciotomy was done. This patient should have had his forearm pressures measured and if they were rising or too high, fasciotomy would he appropriate.

If the swelling was very severe, with loss of motor and sensory function, pulse deficits and excruciating pain out of proportion to the injury itself then fasciotomy would he appropriate without measuring compartment pressures.

These questions cannot be answered from a photograph. I'm sure the Doctor had no intention of "draining" venom.


Any news on how the poor chap is doing?
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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby Bushviper » Tue Dec 07, 2010 1:53 pm

This butcher had no idea what he was doing, of that there is no doubt. It is possible to test the pressure inside the compartments and without this there is no justification for a fasciotomy. Rock hard feel, pain and swelling are normal for these bites and just happens to coincide with SOME of the symptoms of compartment syndrome.

Secondary infection is a far greater threat now than the original bite and the effects.

Jen after-hours you often do not get the profs and the specialists so make sure you get bitten in office hours. It helps if you have a few secret phone numbers on standby to get the treatment you mention above.

Please guys ALWAYS get a second opinion before you allow any operation after a snake bite. From a debridement to amputation needs to be evaluated carefully.
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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby Loslappie » Tue Dec 07, 2010 3:43 pm

Thanks Jen, what you say makes sense.. Ive always said, in case of emergency, save my life and put me together in a Govt Hospital lIke Tygerberg etc and then let em recover in a private Hospital....

Shame the poor man...Im also not a medical dude, only level 3 First Aid.. Jen, would there be bruising on the arm in teh event of Compartment Syndrome?
If it hasnt yet, it will!
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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby Bushviper » Wed Dec 08, 2010 7:28 am

Loslappie bruising would not be related to compartment syndrome. Bruising shows bleeding under the skin where compartment syndrome is the muscle itself being swollen which does not include the bleeding.
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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby Loslappie » Wed Dec 08, 2010 10:09 am

Ahh, Thanks BV Its all good to know!
If it hasnt yet, it will!
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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby Cornelius » Wed Dec 08, 2010 12:29 pm

This is why I thank God that I did the Snakebite identification and treatment course. Best investment of my life by the looks of this.
There is something that is much more scarce, something finer by far , something rarer than ability.
It is the Ability to recognise Ability

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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby Jamster » Wed Dec 08, 2010 1:43 pm

I had a pretty severe reaction to my night adder bite, so I went for a drip and some painkillers, next thing I knew a doctor had ordered 3 doses of B.arientis antivenom to inject me with. I told him hell no, but he insisted.So I told him that it would probably kill me! I told him to phone my boss,Mark Marshall, who sternly prohibited the use of the antivenom. Quite scary...
1.0-reticulated python (Ripcord)
1.1-burmese pythons
5.5-brown house snakes
1.0-taiwanese ratsnake
3.8-BCI
1.1-corn snakes
1.2-rhombic skaapstekers
1.0-yellow rat snake
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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby froot » Wed Dec 08, 2010 1:53 pm

Now where would he find B. arietans antivenom?
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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby Snake Charmer » Wed Dec 08, 2010 1:55 pm

All I can say is that this is scary stuff! I pray that I NEVER have to go through something like this ... :shock:
Repetition builds confidence!

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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby Jamster » Wed Dec 08, 2010 9:34 pm

@ froot- no idea, dont know how it all works, all i know is that i asked to have a look at it. Red and white box in plastic, that had clearly written on it 'B.arientis'. Is this odd in any way? If so, why?
1.0-reticulated python (Ripcord)
1.1-burmese pythons
5.5-brown house snakes
1.0-taiwanese ratsnake
3.8-BCI
1.1-corn snakes
1.2-rhombic skaapstekers
1.0-yellow rat snake
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Re: Stiletto Snake Bite -Atractaspis bibroni

Postby boing » Thu Dec 09, 2010 8:23 am

Jamster wrote:@ froot- no idea, dont know how it all works, all i know is that i asked to have a look at it. Red and white box in plastic, that had clearly written on it 'B.arientis'. Is this odd in any way? If so, why?


You get two types of antivenom for South African snakes...
Monovalent which works only for Boomslang and is not stocked in high quantities due to the fact that Boomslang rarely bite and it is such a slow acting venom. Last time I checked, in PE there was only one vial which was kept at Livingston.
Polyvalent works for a number of species, of which those found in PE include Puff Adder, Cape Cobra and Rinkhals. Last time I checked there was a variety of hospitals who kept it. St Georges had 3, Greenacres 10, and Livingston 50. The other government hospitals do stock as well but I can't remember the quantities. We currently have 6 vials here at the Park.

So, there is no antivenom specific for Puff Adders and that makes it surprising they have it!!
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