Most hospitals can treat snake bites

“Go to Sangre Grande Hospital” This gives the false impression that this hospital is the only one equipped to treat snake bites. This is false. The Augustus Long Hospital Pointe-a-Pierre is also equipped to manage snake bites. Indeed most of our major hospitals can do the basic management. “Anti Venom” and Anti venin are available commercially and all the hospitals need to do is place an order. The general advice to call the hospital first, try to locate the snake but take the victim while others look for the snake are good and commendable advice.

There are 42 different types of snakes in Trinidad and only four are venomous or poisonous. They are:

1. Fer De Lance (Mapepire), 2. Bushmaster, 3. Common coral snake. 4. Large coral snake.

The Mapepire Balsain is a pit viper and has X like marks extending down sides enclosing two dark spots. Mapepire z Ananna (Bushmaster) is a rare pit viper and has light brown with dark brown diamond marks.

The common coral snake (micrurus circinalis) can grow up to 12 inches, thick as a pencil and has colour sequence of the National Flag of TT (red, white and black).

The large coral snake (Micrurus lemniscatus diutius) can grow up to 52 inches, thicker than a finger also with colour sequence red, white and black of the National Flag.

Snake venom is a complex mixture of enzymes, metals and other fractions that can cause tissue damage, coagulopathy, thrombocytopaenia (ie low platelets), hypovolaemia (shock) and neurotoxicity (brain and nerves damage), and cardiovascular toxicity.

Local effects of a snake bite may include immediate burning pain, progressive swelling, ecchymosis, haemorrhagic blebs, tissue necrosis and inflamed swollen glands.

Severity of poisoning may be 1. Minimal: ie local swelling and normal Blood Tests. 2. Moderate: Progressive swelling with one or more systemic effects. 3. Severe: Marked local response, severe systemic effects and significant abnormalities on Blood Testing.

Severity of Poisoning can also be classified as follows: No envenomotion, fang marks only I: Minimal 1”-5” oedema (swelling) and redness in first twelve hours, II: Moderate 6”-12” swelling and redness plus or minus systemic symptoms, III: Severe more than 12” swelling in first twelve hours, systemic symptoms with blood coagulopathy, IV: Very Severe: Rapid Symptoms swelling of one side of the body on which the bite occurred.

Dr Victor Coombs

Pointe-a-Pierre