Saw-Scale Viper Snakebite in Shaba
Yesterday, a 24-year labourer who was lifting rocks was bitten on the hand by what was mistakenly thought to be a small Puff Adder in the Shaba National Reserve in Kenya.
Fortunately a photo was taken of the animal by Sue Heath, and the photo was sent to our colleague, Anthony Childs, who identified it as a fully grown Saw-scaled or Carpet Viper.
Then the phone calls and the e-mails started flying!
Arrangements were made to have the patient med-evac’d to Nairobi Hospital. The senior physician with experience in treating snakebite, Dr. Mauro Saio, was notified that he had a patient coming in with a confirmed viper bite. Two vials of James Ashe Antivenom Trust monovalent Echis antivenom was delivered to the doctor’s hand by Royjan Taylor’s mother, a long time resident of Nairobi.
Then we waited.
We heard nothing more until in the evening when Anton rang Royjan to say a blood test had shown that the patient’s blood was not coagulating. The bite was definitely serious! The venom destroys proper coagulation of the victim’s blood, and the bitten limb may develop necrosis and become susceptible to gangrene.
This is a good place to remind you - if you have been bitten by a snake, DO NOT USE A TOURNIQUET!
This morning the news is quite good. After the blood test, the patient had been given one vial of the monovalent antivenom and, 5 or 6 hours later a further test showed the blood coagulating nicely within 6-10 minutes.
As Dr. Saio told me by telephone, the patient is not completely out of the woods. The hand is badly swollen, kidney function needs to be monitored, and they must watch for a possible fresh surge of active venom from the bite site. Sometimes venom is trapped by the rapid swelling, only to find a way through to the body’s circulation later on.
Hopefully, thanks to James Ashe Antivenom Trust assistance and great teamwork all round, this patient will make a full recovery.