These past few weeks we have seen a surge in the reporting of snake bites as a result of the unusually hot weather. Although it is of a concern, nevertheless there are probably more non-poisonous snakes than poisonous ones in Malaysia.
On most occasions, we are unable to identify the actual snake species that has bitten a victim as it usually slithers away. Actual snake identification allows the emergency doctors to administer specific anti-venom for the species. However it is dangerous to capture a snake unless it is killed (dead) or captured by trained animal handlers. Avoid direct confrontation/contact or risk further bites.
Not all bites cause envenomation i.e. the transmission of snake poison into the body. It all depends on many factors e.g. the snake behaviour, bite depth and the body part exposed or bitten.
However, the Ministry of Health urges all victims to seek help at the nearest emergency department or healthcare centre for assessment. The doctors working in the emergency department will decide to administer antivenom according to severity of the effect of the poison: the speed of its spread or its systemic manifestations or effect to the limb.
Based on the clinical manifestations, the two most common conditions seen are:
1. Effecting the neurological system (pain, headaches, vomiting, blurring of vision, paralysis of the eyelids or the breathing muscles, loss of consciousness)
2. Effecting the haematological system (pain, bruising, severe swelling, bleeding, muscle tissue breakdown, coagulopathy)
A multidisciplinary and inter-ministerial team of experts formed by MOH is currently working on to produce the MOH Clinical Practice Guidelines (CPG) for Snake Bite which will possibly be out by the later part of this year.
Snake antivenom is made from the venom of specific snake type (monovalent) or in combination of several types of snake venoms (polyvalents). It is converted into antidotes through various processes by the industry. While it is safe and can be life saving, it does carry risks for reactions too.
Antivenom is stockpiled in almost all the public hospitals throughout the whole country. There is also a consultative network between health care providers of MOH, University Hospitals and Malaysian Poison Centre for difficult cases of poisoning and snake bite. When necessary, regional centres in ASEAN are activated and can be consulted too. The governments have agreed to allow antidotes and vaccines to be shared with relative ease should the need arises.
What should you do if there is a snake bite victim?
- Call 999 to ask for assistance. Early care directions can be given while awaiting for an ambulance or while the victim is being transported to the nearest most appropriate health facility, be it emergency departments in hospitals or health clinics.
- Reduce movement of the affected part especially the limb. Calm the patient and keep the victim comfortable.
- Do not apply tourniquet or unnecessary compression unless you are a trained first aider or instructed by a professional healthcare providers. Most of the poison spreads through our lymphatic system rather than direct to the blood stream.
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