lying down, quiet, and warm. DO NOT
give alcohol or any other stimulant to
Treat for shock.
Use a splint to immobilize the victims af-
fected extremity, keeping the involved
area at or below the level of the heart.
Cover the wound to prevent further
Give aspirin for pain.
Telephone the nearest medical facility so
that the proper antivenin can be made
Transport the victim (and the dead snake)
to a medical treatment facility as soon as
possible. All suspected snake bite victims
should be taken to the hospital, whether
they show signs of envenomation or not.
Treatment of a nonenvenomated snakebite is
essentially the same as the treatment for puncture
In most situation, the definitive care of the vic-
tim will be in the hands of a medical officer. This
care will center around the use of antivenin serum.
All western hemisphere snakes, with the excep-
tion of the eastern coral snake, can be treated with
the same polyvalent antivenin. This is given in
doses of 3 vials for small reactions; 5 to 8 vials
for cases in which there is swelling of a hand or
foot; and at least 8 vials for moderate or severe
envenomation. Extra vials are kept at the ready.
Children will receive higher doses than adults since
the poison has more effect on them because of
their smaller size and lower weight.
Because the antivenin is a horse serum base,
the medical officer will order a sensitivity test
before it is given. Routine laboratory tests will also
be run in preparation for the possible start of
whole blood infusion.
Additional medical facility care would include
wound cleansing and
debridement, Burows solution soaks, antiseptic
ointment, and sterile dressing.
Bites, Stings, and Punctures from
A number of sea animals are capable of in-
flicting painful wounds by biting, stinging, or
puncturing. Except under rare circumstances,
these stings and puncture wounds are not fatal.
Major wounds from sharks, barracuda, moray
eels, and alligators can be treated by controlling
the bleeding, preventing shock, giving basic life
support, splinting the injury, and transporting the
victim to a medical treatment facility. Minor in-
juries inflicted by turtles and stinging corals re-
quire only that the wound be thoroughly cleansed
and the injury splinted.
Other sea animals inflict injury by means of
stinging cells located in tentacles. This group in-
cludes the jellyfish and Portuguese man-of-war
(fig. 4-69). Contact with the tentacles produces
burning pain, a rash with small hemorrhage in the
skin, and, on occasion, shock, muscular cramp-
ing, nausea, vomiting, and respiratory distress.
Treatment consists of pouring sea water over the
injured area and then removing the tentacles with
a towel or gloves. Next, pour rubbing alcohol, for-
malin, vinegar, or diluted ammonia over the af-
fected area to neutralize any remaining
nematocysts (minute stinging structures). Finally,
cover the area with a dry powder, to which the
last nematocysts will adhere, and then scrape them
off with a dull knife.
Spiny fish, stingrays, urchins, and cone shells
inject their venom by puncturing with spines
Figure 4-69.Jellyfish and Portuguese Man-of-war.