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In Spain, it is estimated that snake bites cause between three and five deaths a year, and children are the most severely affectedTherefore, any suspicion of this type of bite should always be evaluated in a hospital environment, even in the absence of other symptoms.
In other countries these figures increase. And although in rural areas this type of bite is often downplayed, it is not a joke. Urgent pediatric care is essential.
As we go to the pediatrician, we must:
- Wash the area of the bite with plenty of soap and water.
- Do not apply cold or heat local.
- Inmobilize the affected limb, keeping it in the lowest possible position with respect to the rest of the body.
- Try to identify the type of snake. The shape of the bite can help doctors identify the species.
- Never make a tourniquet, unless hospital care is going to take more than an hour and a potentially poisonous species has been identified, or in the case of general symptoms (that is, not only pain and inflammation in the wound area). In such cases, always write down the time when the tourniquet was placed.
Of the five families of poisonous snakes in the world, Spain has two representatives:
1. Family Colubridae (snakes): The most frequent is the bastard snake (Malpolon monpessulanus), present practically throughout the country. In southern Spain and in the Balearic Islands it is also common to cogulla snake (Macroprotodon cucullatus). The snakes have a narrow and elongated head, the pupils are rounded, the scales are large and the tail is long. Although it is extremely subjective, both the character and the 'face' of the snakes they are not very aggressive. They are generally not very dangerous species, since they require time to inoculate the venom after the bite, so they usually retain their prey before doing so.
Snake venom is mildly cytotoxic and neurotoxic. The first effect can lead to significant swelling in the area of the bite, which could lead to serious problems if you do not act with diligence and speed. The neurotoxic effect can cause muscle paralysis, with difficulty speaking, swallowing or breathing. Both effects are exceptional, and it is also rare for the snake to inoculate a significant amount of venom, but they are serious enough complications to remember that a hospital evaluation is always necessary in case of snake bites.
2. Family Viperidae (vipers): Practically throughout the country it is possible to find the nosed viper (Vipera latasti). In addition, in the northwest and in the Cantabrian area there are also specimens of the common or european viper (Vipera berus) and in the Pyrenean and pre-Pyrenean region of the asp viper (Vipera aspis). From a morphological point of view, vipers are very different from snakes: the head is less narrow and triangular in shape, the pupils are vertical, the scales are small, and the tail is short. They are not aggressive and tend to flee in the presence of human beings, although their behavior is unpredictableThey are fast and their 'face' is aggressive.
Viper venom is intensely cytotoxic, hemotoxic, myotoxic, cardiotoxic, and nephrotoxic. The cytotoxic effect is responsible for the intense local inflammation, the most frequent manifestation in our environment, with elevated risk of gangrene and necrosis. Bites to the face and neck present a high risk of mortality due to respiratory compromise that can cause inflammation. The hemotoxic effect produces severe anemia, as well as impaired coagulation, and there is risk of generalized bleeding. The myotoxic and cardiotoxic effects lead to muscle paralysis and cardiac arrhythmias. The nephrotoxic effect leads to acute renal failure and shock. Vipers, in Spain, really kill. So if in doubt, do not hesitate, go to the emergency room.
There are general antivenom and other specific ones for certain types of snakes. Although it is not usual to have them in a health center, they should never be used outside of a pediatric Intensive Care Unit (ICU) and without a first sensitivity test, since they are treatments that, with a high probability, can cause anaphylaxis and worsen the symptoms, already serious, of a snake bite.
Indiana Jones hates snakes. If a person who is capable of defending himself from half the world with a whip and a hat is afraid of these animals, it will be for something. If they cross your path, let them pass.
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