Being taken to hospital quickly and receiving swift medical attention by skilled healthcare professionals, helped save the life of a 74-year-old Pretoria man, who was bitten by a cobra this week.
“The fact that he was brought in so quickly and received prompt treatment by medical and nursing staff here at the hospital, no doubt helped save his life,” says Dr Kat Myburgh, a doctor who practices at Netcare Montana Hospital’s emergency department, of the patient.
The snakebite victim was brought to Netcare Montana Hospital’s emergency department with a tourniquet around his lower right leg on Saturday evening. The snake bit him in his home, on a smallholding near Bon Accord Dam. “His neighbour, who rushed him to the hospital, also brought in the dead snake, which meant we knew exactly what we were dealing with from the outset,” adds Dr Myburgh.
Dr Myburgh said she thought it was an Egyptian cobra, but nevertheless contacted Pretoria-based snake-expert, Andre Lourens, to conclusively identify the snake, in order to determine the most appropriate treatment plan. It was important to establish if the snake’s venom was cytotoxic (toxic to the cells) or neurotoxic (attacks the nervous system). As it turned out, Egyptian cobras have neurotoxic venom.
Dr Myburgh said that the medical team removed the tourniquet and intubated the elderly man to help him breathe. He was later admitted to the intensive care unit (ICU) of Netcare Montana Hospital.
As the patient was still conscious, the doctors did not initially administer any antivenom, but did so when the need arose. She explains: “It is important to remember that snakes do not always inject venom when they bite someone, this is referred to as a dry snakebite. On occasion, the venom may even spill out of the bite. It is not advisable to administer the antivenom, until you can gauge the true extent of the problem from the wound.”
Dr Johan van Beljon, the specialist surgeon under whose care the patient was admitted said: “The bite marks look fine and there is no tissue necrosis. We extubated him this morning and he is doing well. The patient is expected to be discharged soon and has fortunately not suffered any lasting harm as a result of the snakebite.”
In terms of the care that should be given to victims of snakebite, Dr Myburgh advises against using a tourniquet, and suggests that a pressure bandage would be a better choice. This, in combination with keeping the patient as still as possible, will help slow down the action of the venom.
“Get help as fast as possible. Do not cut the wound or try to suck out the poison, as this will damage the tissue surrounding the bite,” she warns.
In the event of a bite from a snake with cytotoxic venom, it is wrong to administer a tourniquet, as this concentrates the venom in one part of the body, where it could do great harm, and potentially lead to the possibility of amputation.
Caution ahead of snakebite season, from snake expert
Lourens cautions that this is the time of year when snakes tend to be more active. “Snakes are on the move at this time of year,” he notes. “Breeding season has just passed. They are laying eggs and are feeding.”
This past week alone he had been called out to catch several snakes, including a venomous Rinkhals, otherwise known as a ring-necked spitting cobra. According to Lourens, Egyptian, or Snouted, cobras are particularly common in the rural parts of Southern Africa.
- Neighbour tells how patient was saved
The neighbour of the snakebite victim, later described on Facebook how he came to the aid of the elderly man and managed to get him to hospital within approximately 30 minutes of being bitten.
“All the staff seemed to know exactly what to do. Within minutes the snakebite expert arrived and quickly identified the snake. Soon my neighbour was on a drip. He was later transferred to the ICU of the hospital and is currently recovering,” he wrote.
“Bearing in mind that my neighbour is 74 and has had heart surgery twice, the situation was quite dire until he received proper, professional medical attention. I would like to extend my gratitude towards the staff at the hospital, you guys really impressed me,” he wrote.
Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare Montana Hospital
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville, Thomas Hartleb or Devereaux Morkel
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