Snake and Insect Bites

SNAKE AND INSECT BITE
Enita Dewi., S.Kep., Ns., MN
Jl. A.Yani Pabelan, Kartasura, Surakarta – Indonesia 57162

Telp.: +62-271-717417, Fax. +62-271-715448
Website: www.ums.ac.id, email: ums@ums.ac.id
SNAKE BITES
Snake bite is one of the major public

health problem in the tropic. It is also an
emerging as an occupational disease of
agricultural workers. A snakebite is an
injury caused by the bite of a
snake, especially a venomous
snake.
Telp.: +62-271-717417, Fax. +62-271-715448
Non Poisonous Snakes
Head - Rounded
Fangs - Not present
Pupils - Rounded
Anal Plate - Double row
Bite Mark - Row of small
teeth.
Poisonous Snakes
Head –Triangle
Fangs –Present
Pupils - Elliptical pupil
Anal Plate - Single row
Bite Mark - Fang Mark
Venomous Snakes in Indonesia
Only a few poisonous

snakes in Indonesia:
1.Ular sendok )arboC(
2.Ular anang gnudeT(
)arboC gniK uata
Ular sendok
3. Ular Welang
4. ular Weling
5. Ular Hijau Pucuk
)kuwul gnudag(
6. Ular taliwangsa gnaleb(
)gninuk-matih
7. Ular tanah aut talkoc(
)gnajnap gnirat nagned
Ular gadung Luwuk
Neurotoxic venom
– Neurotoxic venom tends to act more quickly, attacking

the nervous system and stopping nerve signals
getting through to the muscles. This means paralysis,
starting at the head, moving down the body until, if
untreated, the diaphragm is paralysed and the patient
can't breathe
– In contrast, neurotoxic venoms, which are typical of the
Elapidae snakes (mambas, cobras, and corals), contain
a number of toxins that primarily affect the
peripheral nervous system, in particular the
neuromuscular junction.
Snake traits
• Fear of humans
• Bite to warn / repel humans (most cases). ( ) 70%
.sekans suomonev morf ton era setib ekans
• Generally, little or no poison was injected.
• Snake bites don't all end in death. Death does not
come immediately or in a few minutes.
• Symptoms usually appear 15 minutes to 2 hours later
after the victim was bitten by a snake.
ASSESMENT
• Assess the patency of the patient's airway and the
adequacy of oxygenation and ventilation. Ensure the
patient has adequate perfusion.
• Assess for local damage. Crotalid envenomations are
characterized by swelling, tenderness, and bruising.
Hemorrhagic blebs may develop over several hours.
Fang marks may be obscured by swelling
• Systemic toxicity following crotalid envenomation may
include nonspecific signs and symptoms such as
nausea, headache, and lightheadedness
Telp.: +62-271-717417, Fax. +62-271-715448
Swelling and bruising after crotalid
envenomation

Telp.: +62-271-717417, Fax. +62-271-715448
Hemorrhagic blebs

Telp.: +62-271-717417, Fax. +62-271-715448
Telp.: +62-271-717417, Fax. +62-271-715448
The goal of therapy in snake
bites
• Reducing the risk of systemic absorption

of snake venom
• Minimizing the clinical effects of snake
venom
• Reducing the risk of death from snake
bites
FIRST AID
• Lay or sit down with the bite in a neutral

position of comfort.
• Remove rings and watches before swelling
starts.
• Wash the bite with soap and water.
• Cover the bite with a clean, dry dressing.
• Mark the leading edge of
tenderness/swelling on the skin and write
the time alongside it.

Telp.: +62-271-717417, Fax. +62-271-715448
DON’T
• Do not pick up the snake or try to trap it
• Do not wait for symptoms to appear if bitten, get
medical help right away
• Do not apply a tourniquet
• Do not slash the wound with a knife or cut it in any
way
• Do not try to suck out the venom
• Do not apply ice or immerse the wound in water
• Do not drink alcohol as a painkiller
• Do not take pain relievers (such as aspirin, ibuprofen,
naproxen)
Telp.: +62-271-717417, Fax. +62-271-715448
ANTI SNAKE VENOM
Antivenom, also known as antivenin, venom antiserum, and

antivenom immunoglobulin, is a specific treatment for
envenomation. It is composed of antibodies and used to treat certain
venomous bites and stings. Antivenom is a mixture
of hyperimmune globulins and other proteins obtained from the
serum of animals (horses, sheep) that have been immunized with
the venom of a snake.
Telp.: +62-271-717417, Fax. +62-271-715448
INSECT BITES
Less severe reactions to bites and stings may

trigger signals including:
• A bite or sting mark
• A stinger, tentacle or venom sac
• Redness
• Swelling
• Pain or tenderness.
Severe allergic reactions to bites and stings
may bring on a life-threatening condition
anaphylaxis.
Telp.: +62-271-717417, Fax. +62-271-715448
INSECT BITES
Between 0.5 to 5 percent of Americans are

severely allergic to substances in the venom of
bees, wasps, hornets and yellow jackets.
When a highly allergic person is stung, call 9-1-
1 or the local emergency number immediately
for medical care.
For most people, insect stings may be painful or
uncomfortable but are not life threatening.

Telp.: +62-271-717417, Fax. +62-271-715448
INSECT BITES
To give care for an insect sting

• Examine the sting site
• If the stinger is still present, remove it to
prevent any further poisoning
• Wash the area with soap and water and
cover the site, then apply ice or a cold
pack
• Observe the victim for signals of allergic
reaction

Telp.: +62-271-717417, Fax. +62-271-715448
NURSING CARE
Dx: Ineffective airway obstruction related to endotoxin reaction

Goal: Demonstrate clear breath sounds, respiratory rate within normal
range, free of dyspnea/cyanosis
Interventions:
1. Maintain the client's airway. Rationale: Increase lung expansion.
2. Monitor the frequency and depth of breathing. Rationale: Rapid/shallow
breathing occurs due to hypoxemia, stress, and circulating endotoxins
3. Auscultate breath sounds. Rationale: Difficulty breathing and
adventitious sounds are indicators of pulmonary congestion/interstitial
edema, atelectasis
4. Change position frequently. Rationale: Good pulmonary clearance is
necessary to reduce ventilation/perfusion imbalance
5. Give O2 through appropriate means, such as a face mask. Rationale: O2
corrects hypoxemia/acidosis. Humidification reduces the drying of the
respiratory tract and decreases the viscosity of sputum

Telp.: +62-271-717417, Fax. +62-271-715448
NURSING CARE
DX: Hyperthermia related to increased metabolic rate, disease,

direct effect of circulating endotoxin, infectious process
Goal : Demonstrating that the temperature is within normal limits
(36-37.5oC), free from cold.
Intervention:
1. Monitor the client's temperature. Rationale: Temperature 38.9-
41.1oC indicates an acute infectious disease process
2. Monitor intake and output and provide preferred drinks to
maintain a balance between intake and output
3. Give a warm compress bath, avoid the use of alcohol. Rationale:
Can help reduce fever, because alcohol can make dry skin.
4. Give Antiperitik according to the program. Rationale: Used to
reduce fever with its central action on the hypothalamus

Telp.: +62-271-717417, Fax. +62-271-715448
Te r i m a k a s i h

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SNAKE AND INSECT BITE

Enita Dewi., S.Kep., Ns., MN

Jl. A.Yani Pabelan, Kartasura, Surakarta – Indonesia 57162

Snake bite is one of the major public

Only a few poisonous

– Neurotoxic venom tends to act more quickly, attacking

Jl. A.Yani Pabelan, Kartasura, Surakarta – Indonesia 57162

Jl. A.Yani Pabelan, Kartasura, Surakarta – Indonesia 57162

• Reducing the risk of systemic absorption

• Lay or sit down with the bite in a neutral

Jl. A.Yani Pabelan, Kartasura, Surakarta – Indonesia 57162

Antivenom, also known as antivenin, venom antiserum, and

Less severe reactions to bites and stings may

Between 0.5 to 5 percent of Americans are

Jl. A.Yani Pabelan, Kartasura, Surakarta – Indonesia 57162

To give care for an insect sting

Jl. A.Yani Pabelan, Kartasura, Surakarta – Indonesia 57162

Dx: Ineffective airway obstruction related to endotoxin reaction

Jl. A.Yani Pabelan, Kartasura, Surakarta – Indonesia 57162

DX: Hyperthermia related to increased metabolic rate, disease,

Jl. A.Yani Pabelan, Kartasura, Surakarta – Indonesia 57162

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