Snake Dharma

August 19, 2007 at 3:04 pm | Posted in Agkistrodon, antivenom, Bitis, Cincinnati, Crotalus, Dr. George T. McDuffie, herpetology, horse protein allergy, Lusaka, McDuffie, Roger Stuebing, Vincent | 3 Comments

Mahil’s comment in the previous post made me think. I was particularly reminded of my first few hesitant months in the U.S. way back in 1974. I had come to study Biology and was trying to find my feet in this strange new place. It was a bit of an adjustment. I had been brought up in Africa, with very few people, infrequent electricity and ingenious but primitive seeming technology. For example, our fridge ran on methylated spirit and baking cakes in a firewood fed oven is a real challenge.

I was just as terrified of snakes as my fellow humanbeings right till the age of 11, which is when I ran into my first ‘snakeman’. There was a small reptile collection in what passed for a zoo at Lusaka. There I spent a day in 1969 and was amazed to see the local ‘snakeman’, one Mr. Vincent, casually handling snakes that I knew to be very dangerous. He eventually convinced me to pick up a Whip Snake (Psammophis), and it wasn’t slimy, in fact quite dry, and even pleasant to hold!

That made all the difference! I became a friend, and wherever possible, protector of snakes. Shortly thereafter I found a 2 foot long black snake (unidentified) in our garden, and coaxed it into a large bottle and hid it in my bureau. I then took off to play. Unfortunately, the next morning my mom suddenly got the urge to clean my (admittedly messy) room. She casually pulled out the big bottle and set it on the dresser and kept cleaning till she thought she saw something move. Needless to say, things went downhill rapidly after that. I got home to find my mom shaking with fury, refusing to enter the house, and my dad looking rather helpless.

Anyhow, skipping forward a few years, here I was in Cincinnati, staying with my sister and her hubby (the Jeyaveerans) when a close friend of theirs dropped by. Roger Stuebing was an expert in statistics and worked at the U.C. computer center. Roger decided to try and help me out with my acclimatisation. We got to chatting and soon found that we had a lot of common interests one of which was snakes. A few days later Roger picked me up early and we headed out to join my first American snake collection trip.
Now, if Vincent had been interesting that was mild compared to Dr. George T. McDuffie. A Ph.D. in herpetology (that roughly covers the crocs, gators, snakes, lizards, turtles, frogs and salamanders), McDuffie lived in a big brownstone with a huge basement. We joined an assortment of folks at his place and headed out to the hills. We were after any snake, but he was particularly interested in copperheads (Agkistrodon contortrix)
and timber rattlers (Crotalus horridus – below) both pit vipers.

McDuffie had his right arm in a sling and as we drove, the conversation veered round to his most recent snakebite, and hence the sling. It
turns out that he had been bitten by a rattler 3 days back and had a slightly swollen and painful arm. He had lost count of the number of times he had been bitten, but it had reached the stage where he had developed some natural antivenom (immunity) and McDuffie had also become allergic to the usual (horse protein based) antisnakevenom, and so could not be treated with that at all!

I had no idea what pit vipers were, so the day turned out to be very interesting indeed. We found one beautiful timber rattler and McDuffie had it on his snakestick when I saw someone struggling to hold the sack open with two more sticks. I promptly picked up the sack and held it up for the snake to be lowered into between my outstretched hands. McDuffie calmly let the snake down into the sack and I bagged the snake and handed the bag to McDuffie.

He then looked intently at me and said “that was a very brave thing to do”. I was really puzzled and asked what other way there was to bag snakes. Only then did it dawn on McDuffie that I may not know what pit vipers were! Indeed, in Africa there are a plethora of venomous snakes but no pit vipers.
The common vipers in Africa were the Puff Adder (Bitis arietans, not shown) and the very striking Gaboon Viper (Bitis gabonicus – left), neither of which have the heat sensing capability of the pit vipers.

That beautiful, big, timber rattler could clearly ‘see’ my hands as two large, live, hotspots on either side of its head as it was being lowered into the sack, and I didn’t even have a clue as to the danger that I was in!

That was the same snaking trip where McDuffie caught a big Black Racer (Coluber constrictor)using only his teeth, but that tale can wait, as can the account of what we found in that large, hot, basement of his after we got back…

Bitten to the point of immunity, McDuffie really did live-out his dharma. I was saddened to hear that George died (apparently of natural causes) this April at the age of 79 – a true snakeman and fondly remembered!

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Snakes in the (Indian) Grass

August 12, 2007 at 7:27 am | Posted in antivenin, antivenom, Bungarus, common cobra, common krait, Daboia, Echis, Hypnale, king cobra, Naja, Ophiophagus, Russell's viper, saw scaled viper, snakebite, Trimeresurus, venomous | 3 Comments

A ‘narcissistic’ Indian Cobra

INDIA’S “BIG FOUR

(Naja naja)

The Russell’s Viper

Echis carinatus – the Saw Scaled Viper
Notice how variable the colouring can be.


Saranya, my 19-year-old daughter, just recovered from a snakebite this week. I haven’t really kept myself very up-to-date on the developments in treating snakebites for the last couple of years as my snake rescue work has almost been non-existent of late. It’s very good to see that the next generation is showing an interest in preserving these wonderful, though somewhat dangerous creatures!

Now that I’ve had to brush-up, I thought I would take the opportunity to summarise the steps to be taken when bitten by a snake…

First and foremost, no snakebite should be ignored. Most bites may be from nonpoisonous snakes and sometimes even venomous snakes do not deliver enough venom when biting to prove dangerous, but that is no excuse not to go to the nearest emergency room, get evaluated, and if necessary, have treatment started. Early treatment is the key to preventing complications, and to saving lives, limbs and kidneys!

In India, it is estimated that up to 20,000 people die annually from snakebites. Morbidity is also significant. These are not small numbers, and there seems to have been little improvement in reducing the fatalities over the years in spite of now having good supplies of polyvalent antisnakevenom available in all population centers. The major reason for the high mortality rate (about 5% to 10% of all those reporting bites) is the delay in getting the victim to a well-equipped casualty treatment facility fast enough.

About 80% of the venomous snakebites in India come from the saw scaled viper (Echis carinatus) and this little fellow can cause problems a little more slowly than the others of the “big four” (cobra, krait and Russel’s viper) so it’s probably true that a lot of the fatalities that do occur are in fact preventable.

FIRST AID:
In the absence of a nearby doctor, those accompanying the bitten one need to first calm the victim down and then immobilise the affected limb (if it is a limb). Pressure bandages, tourniquets, and cutting into the site of the bite to suck out the venom (all of which were the mainstays of first aid in my heyday) seem to have fallen out of favour.

Next, get the person to the nearest hospital as fast as possible. Walking and running for the victim are best avoided. The victim should be encouraged to breathe deeply and evenly to bring the pulse rate to a steady state. Those having cell phones should call ahead so that even if antivenom is not available, it will be made available by the time the patient arrives. remember that 5, 10, or even more vials of antivenom may be needed, so ask whoever is at the other end to ensure an adequate supply.

Observe the snakebite victim carefully while taking them to the hospital. Note the time and location of the bite and try to get as much accurate information on the appearance and size of the snake. Any symptoms such as discolouration at the site or of the affected limb, swelling, changes in eyes (e.g. droopy lids), eyesight, speech, breathing, sweating, unusual eye movements, bleeding, lowered level of consciousness or other difficulties should be noted.

TREATMENT:
Mostly, if there are symptoms, the doctors will immediately do a spot test dose in the skin of a forearm to check for allergies to the antivenom. Depending on the symptoms, they may then start the antivenom treatment and then one will most profitably spend one’s time praying that there will be no complications.

On admission, and at relevant intervals afterwards, the doctors will probably check on how well the blood is clotting (bleeding time, clotting time, and sometimes tests like PT and aPTT), kidney function (urine output, blood urea, creatinine and electrolyte levels), and of course the vital signs – pulse, breathing, temperature, blood pressure and the amount of oxygen in the blood (pO2). They may also keep tabs on the patient’s haemoglobin, blood cell counts, and perhaps the blood gasses too.

Sometimes even after a day or two, things can go wrong, with the patient starting bleeding, kidney failure, or even the heart could be affected, so keeping the victim under medical observation even after the antivenom has been administered is important. Most of the time, alert medical staff will successfully deal with the crises as they arise.

Saranya was probably bitten by the Saw Scaled Viper (Echis, see above), but sometimes a non-big-four candidate can cause trouble. In our our area of South India, especially in hilly areas, we do run into bites from the Hump-nosed Pit Viper (Hypnale hypnale)

or the Bamboo Pit Viper (Trimeresurus gramineus) and very, very rarely, the king cobra (Ophiophagus hannah).

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