Sop OPOP - 048 - Snakes and Snake Bites

Systems Procedure OPOP 048
Rev. 02
Snakes and Snake Bites
Page 1 of 16
Responsible Department: OPOP
A. PURPOSE:
To provide a Standard Operating Procedure for all MCC sites and operation to ensure
to ensure that employees working at a Mine, know what to do when encountering a
snake. It must be noted that areas may have different types of snakes and need to be
addressed accordingly
B. SCOPE:
This Standard Operating Procedure is applicable to all MCC sites and operations
This procedure excludes the following:

 None
C. DOCUMENT OWNER:
Theo Silver – MCC Project Manager
D. REVIEW TEAM:
 MCC Project Manager
 MCC Trainer
 MCC Full Time Safety Representative
 Shop Steward FMU
 Shop Steward NUM
 Superintendent
 HOD OPOP
An uncontrolled copy of this document (without original stamp and signature of process owner) is only valid for the day of
Tuesday, 17 July 2012
Rev. 02
Page 2 of 16
E. APPROVED BY:
Signature / Signature / Signature Date / Date / Date
MCC Project Manager: T. Silver
F. AUTHORISED BY:
HOD: Jan Gerber
PROCESS FLOW:
N/A
1. DESCRIPTION OF PROCESS:
1.1 Responsibilities
The Project Manager and Engineering Manager must ensure that all employees inspecting or working
in the opencast area are instructed in this procedure and equipped with effective protective equipment
i.e. gloves - safety boots – goggles etc. that can assist in reducing immediate spits or bite risk
exposures from snakes
It is advisable to ensure that the medical facility closest to the site or operation has the
necessary medical snake or spider bite serums available.
1.2 Types of snakes that are poisonous
 Black mamba
 Boom slang
 Egyptian cobra
 Forest cobra
 Mozambique spitting cobra
 Puff - adder
 Twig or bird snake
Rev. 02
Page 3 of 16
1.3 Appearance during season
 Most snake bite cases occur during the dry cool months (March - June)
 Snakes are much more active in a humid climate.
 Just before hibernating during the winter months, the snakes spend most or their time
 around food and nesting.
1.4 General guides if bitten by a snake
 Immediate burning pain followed by swelling.

 Dizziness, difficulty with swallowing and breathing.
 Severe headache usually several hours after the bite.
 Bleeding could follow from small cuts.
 Severe internal bleeding may follow.
 Vomiting could follow.
1.5 Prevention of snake bites
 Leave snakes alone

 Wear stout shoes or boots
 Do not walk barefoot at night
 Keep your eyes open and look where you are going
 Do not reach into holes, burrows and hollow logs
 Do not place your hands in places that are out of sight
 Do not step over logs and large rocks as a snake may sunning itself
 If you come across a snake - stand perfectly still
 If 4 metres or more retreat slowly - snakes do not chase people
 Do not try to kill a snake - thus looking for trouble
 Do not tamper with seemingly dead snakes - some feign death
 Treat all snakes with respect
1.6 Snake bite symptoms

 Eyelids start sagging
 Eyes start to squint
 Speech slurred
 Difficulty in breathing
 Victim starts turning blue
 Severe swelling and severe pain at wound
 Area around wound gets red and hot
Rev. 02
Page 4 of 16
 Internal bleeding , blistering and death of tissue

 Restlessness
 Severe headaches
 Blurred vision
 Laboured breathing
 Nausea - vomiting
1.7 Treatment of snake bites

 Your immediate reaction / treatment is extremely important and could save a life.
 Heart massage and mouth-to-mouth respiration
 Apply a broad, firm pressure bandage over the bitten area
 Do not use tourniquet
 Remove victim's shoes
 Keep victim clean and reassure victim
 Ensure victim does not move – movement increases venom circulation
 Do not give victim alcohol or cut the area where bite occurred.
 Call for doctor - give advance warning to doctor. Identify snake type if possible.
 Do not inject anti-venom
 Keep mouth and throat clear of saliva
 Do not hunt the snake down
 If the snake is dead take it with to the doctor
 Keep your wits – react in a logical way
 Do not suck the bite
 Ensure snake is no longer in the immediate vicinity
 Make use of gloves at all times
 Don't allow the victim to talk
 Transport on stretcher
Additional information: (1)
FIRST AID in SNAKEBITE:
DO NOTS
1. DO NOT INJECT ANTIVENOM. Unless you are hours away from a physician or medical
facility anti-venom should not be injected by the layperson. Anti-venom is refined from
horse serum and a percentage of people are highly allergic to it. Anaphylactic shock
WILL kill your patient - whereas the patient stands a good chance of surviving the bite
without anti-venom. Anti-venom is best left to the professionals in a proper facility where
life-support systems are available. It should normally be unnecessary for the layperson to
use anti-venom anywhere within the Peninsula.
Rev. 02
Page 5 of 16
2. DO NOT CUT INTO THE BITE All you will probably do is assist the venom to spread
more rapidly.
3. DO NOT SUCK ON THE BITE If you have cuts in your mouth there will be two patients
where there was one. If you have a suction device it may be applied or you can attempt
sucking through a dental dam - should you have one handy.
4. DO NOT APPLY ELECTRICAL SHOCK TO THE PATIENT A myth has grown up that
application of shock or a stun gun is of assistance. This is a pure myth without any basis
in fact whatsoever. You are more likely to kill than cure using this method.
5. DO NOT GIVE DRUGS OR INTOXICANTS TO THE PATIENT Unless advised by a
medical practitioner. Applications of these substances make diagnosis far more difficult
once you arrive at the hospital.
6. DO NOT RUB TOPICAL SUBSTANCES INTO THE WOUND You may clean the wound
with a little mild disinfectant and dress it lightly with something like Betadine ointment -
but preferably leave it alone.
7. DO NOT APPLY A TOURNIQUET You are likely to do far more damage with the
tourniquet than without.
8. DO NOT APPLY ICE OR HEAT TO THE WOUND Neither is of any use - but both may
harm.
Shock - How to Recognise and Treat
Shock is a condition in which the circulatory system fails to circulate blood throughout the
body properly. It is a progressive deteriorating condition that can be fatal. It is present to
some degree in ALL physical trauma Shock CAN kill. The first indication that a person is
going into shock is restlessness or irritability.
Some of the symptoms of shock are:
 Heavy or difficult breathing

 Rapid breathing
 Racing or Pounding heartbeat
 Rapid, weak pulse
 Excessive sweating
 Pale or bluish skin
 Excessive thirst
 Nausea, vomiting
1. Drowsiness or unconsciousness.
 Although it is impossible to care for shock by first-aid alone, you can take measures that
could be life-saving. First-Aid Treatment for shock is:
 Reassure the victim and keep him/her calm. Help them rest comfortably (pain can
intensify the body's stress, which accelerates shock).
Rev. 02
Page 6 of 16
 Have the victim lie down. Keeping them comfortable is the key.
 Keep your patient from becoming overheated or chilled. If a source of cold water is
nearby, wet a cloth and wash their face regularly and lie them in the shade. If it is a cold
day, wrap them in a blanket.
 If you sense that the victim is slipping into unconsciousness, take measures to prevent
this from happening.
 Above all, keep the victim comfortable! Strike up a conversation with them and continue to
reassure them.
 Once shock sets in, the victim's condition will continue to deteriorate, so getting help or
getting the victim to help ASAP is the most important thing.
The first aid of choice, in snakebite, is the pressure bandage

The aim of the pressure bandage is to immobilise the limb and restrict the flow in the
lymphatic system. This will slow the transport of the venom dramatically giving you the
few hours extra to transport the patient to a well-equipped facility where medical
practitioners can take over. A word of advice - many medical men have never seen or
treated snakebite. It is fairly rare. Telephone your nearest Poison Centre, University or
Snake Park. They usually are able to give advice on physicians with experience of
handling snake envenomation. You may ask the treating physician to consult with such a
person. Application of the pressure bandage: Get the victim to lie down immediately.
Relax and reassure them. Keep calm yourself - you will have enough time. Talk soothingly
and be confident. Using a crêpe bandage (or torn up strips of material) bandage the bitten
limb. Start at the bite site and work upwards. Do not remove clothes as the movement
required will assist the venom to spread. Wrap the limb as tightly as you would for a
sprain. Firm, but do not cut off the blood supply. Apply a splint to the limb to immobilise it.
Avoid massaging or rubbing the bite area. Do not remove the pressure bandage until
medical personnel are ready to start treatment.
Rev. 02
Page 7 of 16
1. 2.
A VICTIM OF A PUFFADDER BITE TO THE

ANKLE
IS MADE TO LIE DOWN IMMEDIATELY
A PRESSURE BANDAGE, ST
3. ARTING AT THE BITE SITE, IS BEGUN
4.
THE BANDAGE IS TAKEN

AS HIGH UP THE LIMB AS POSSIBLE
THE WIDE CREPE BANDAGE IS

BOUND AS TIGHTLY AS FOR A SPRAIN
5.
6.
THE SPLINT IS BOUND TO THE LIMB

A SPLINT IS APPLIED SO AS TO IMMOBILISE IT
TO THE PRESSURE-BANDAGED LIMB COMPLETELY
7. 8.
Rev. 02
Page 8 of 16
THE LEG IS NOW

COMPLETELY IMMOBILISED BY THE
SPLINT THE PATIENT IS NOW READY
TO BE TRANSPORTED TO A HOSPITAL
Some things to do
 Make a note of the time the bite occurred. This will help physicians to check on the
progress of the venom.
 Remove constricting jewellery.
 Rapid swelling may make such items as rings and bracelets into objects of great pain.
 If possible phone ahead and clearly explain to the hospital that a possible snakebite
case is on the way. If a positive identification of the snake can be made, make sure
they know what to expect.
 Be prepared to render artificial respiration in the case of a cobra bite. A dangerous
sign of impending lung paralysis is when the victim cannot blow out a match held at
arms length. The venom does not kill - the inability to breathe is what causes death.
 Be prepared to keep the airways open and make sure the patient does not drown on
his own saliva.
 Keep the patient as immobile as possible and transport to a hospital.
 Keep in mind that shock is probably present in all snakebite cases, whether from
venomous or non-venomous species. Shock can kill even more rapidly than snake
venom. Acquaint yourself with the symptoms of shock. Be prepared to deal with shock
symptoms in ANY snakebite victim. Even those bitten by non-venomous species.
People have died of such bites in the past.
Rev. 02
Page 9 of 16
MEET THE VENOMOUS SNAKES OF THE PENINSULA
Naja Nivea - Cape Cobra, Geelkapel, Koperkapel.
They are said to be more aggressive during the mating season - which is usually from
September to October. A bite from a Cape Cobra constitutes a grave medical
emergency. Its venom is as potent as a Black Mamba's - but it injects less of it.
Transport the patient as rapidly as possible to a medical facility after pressure bandaging.
Be prepared to support breathing.
Bitis Arietans - Puff adder, Pofadder
Rev. 02
Page 10 of 16
The venom is potently cytotoxic and a bite from it is a fairly serious medical emergency.
It may take hours before symptoms start to develop. Pressure bandage and transport
patient to the nearest large medical facility.
Dispholidus Typus – Boomslang

The venom is dangerously haemotoxic and destroys the coagulant properties of the blood.
Additional information: (2)
Rev. 02
Page 11 of 16
SNAKEBITE STEP BY STEP

FIRST AID 1. Wrap a crepe or pressure bandage firmly around
the area of the bite,
2. covering the entire limb - apply hand pressure at
the site of the bite until a
3. bandage can be obtained. If none is available,
strips of fabric can be
4. used. The bandage should slow down the blood
flow NOT stop it
5. altogether.
6. If splints are easily available, bind them to either
side of the limb to
7. immobilise it - tent poles or straight branches will
do.
8. Raise the limb to slow the blood flow.
9. Keep Calm - give the patient support and
QUICK GUIDE reassurance. Do not allow the
10. patient to move unnecessarily.
11. Observe the patient - record the symptoms
and the time taken to appear,
12. also the circumstances of the bite.
APPLYING A PRESSURE DO 13. NOT!!!!
BANDAGE 14.Use Act
1. quickly except
antivenom and calmlyin a with careful
hospital planning.
environment.
Slow the Blood Flow, Do Not 2. Cut and suck the wound.
3.
15.ApplyGeta tourniquet,
to hospital ie,
as binding
soon asthat stops the blood
possible.
Stop IT flow. This can cause cell damage and possible
loss of limb.
4. Move the patient unnecessarily.
5. Waste time.
6. Try to catch or kill the snake; identification is not
crucial for treatment.
7. Panic, death from snakebite is very rare.
8. Give the patient any stimulants, eg. Alcohol.
Bandage from fingers to armpit 9. Give the patient any food or drink; this may impede
breathing.
10. Rub potassium permanganate into the wound
Start bandaging anywhere, Just or soak the limb in home remedies.
Start 11. Assume the worst; more people die from bee
stings than snakebites.
12. Neglect medical treatment for shock in any
snakebite, even non-venomous bites.
Fang group + species Venom type + symptoms Time see variables
Cytotoxic venom attacks the
Bandage from toes to groin cells and tissue especially blood
and vessels which results in
ALWAYS WRAP THE ENTIRE LIMB
Hinged front fang. Adders extreme pain, swelling of the 24 hours – 2 weeks
FIRMLY
+ spitting type. affected limb and blistering.
Untreated bite may result in
death due to loss of blood,
Rev. 02
Page 12 of 16
dehydration and secondary

infection.
Neurotoxic venom affects the
breathing of the patient. Early
symptoms; “pins + needles”
Fixed front fang. Mamba + sensation, dizziness, poor co- 30 minutes – 6 hours
Cobra type. ordination, slurred speech,
excessive saliva at the mouth and
drooping eyelids. This followed
by extreme difficulty in breathing
and eventually death.
Heamotoxic venom attacks and
“thins” the blood allowing the
venom to seep through the walls
of the veins. Early symptoms;
headache, nausea, diarrhoea,
Back fanged type. Adder + lethargy, mental disorientation, 4 days – 3 weeks
Spitting Cobra. bruising and bleeding at the bite
site.
This could result in death
because of the difficulty in
stopping the bleeding. For this
type of snake to bite effectively it
must be able to open its mouth
completely to sustain an effective
bite.
IMPORTANT FACTS TO REMEMBER

1. Neurotoxic venom is fast acting whereas Heamotoxic is slow acting. If you are unsure
whether the snake is venomous or not follow step by step FIRST AID. Symptoms will
develop within an hour.
2. Puff adders are responsible for 70% of all bites and are one of the fastest striking
snakes and can strike both to the front and side. They are aggressive and will not give
way to you.
3. Venom of the Spitting Cobra is only harmful if it enters your eye or a cut or wound on
your body. If the venom does enter the eyes the following must be done; the “spray”
will sting like soap, rinse the eyes with clean water or any liquid not dangerous to the
eyes even urine will be effective. Cover the eyes with a cloth or dark glasses as the
eyes will be very light sensitive. Remember, Spitting Cobra are fixed front fanged
and can spit almost constantly from varied positions.
Rev. 02
Page 13 of 16
4. Boomslang or Tree snake, vary considerably in colour from young to an adult and
male to female. Colour varies from brown + grey to green.
5. Vine snakes are very well camouflaged and bites from this snake are rare. There is no
venom available for this snake and the symptoms are treated as they arise.
6. Berg adders are predominantly Neurotoxic; symptoms could include optical paralysis.
7. A snakes tongue is not harmful. It is the snakes taste and smell organ.
Quick, calm action saves time, saves lives.
VARIABLES
(Factors influencing the severity of AVOID BEING BITTEN
the bite)
1. Be Aware – watch where you step.
8. Amount of venom injected. 2. 90% of snakebites are due to catching or trying to
9. Site of bite – head; neck;
trunk. kill snakes – Leave them Alone!
10. Tissue type – muscle; vein; 3. Wear boots and long trousers in the bush or veld,
artery. especially at night.
11. Depth injected – deep or 4. Step on top of, NOT over logs or rocks.
shallow. 5. If you need to move rocks take relevant
12. Reaction of patient – calm or precautions.
shock/panic.
13. Physical health of patient. 6. Do not place your hands/feet into holes in the
14. Age of Patient. ground or in trees.
15. Physical size of patient. 7. Do Not place your fingers under rocks, logs or any
16. Sensitivity of patient – hyper- object when picking them up.
allergic. 8. Stay away from dead snakes – many fake death in
17. Time taken to receive
treatment. self-defence.
18. Type of first aid treatment
given - Ref. Step by Step First Aid.
19. Type of medical treatment SNAKES BITE IN SELF-DEFENCE - NB!!!!
received. 9. You do not have to catch, kill or even identify the
20. Disposition of the snake and snake for effective treatment
circumstances surrounding the 10. The doctor will establish which of the three groups
bite. the snake belongs to, by the symptoms of the
patient.
HOW TO IDENTIFY SNAKES 11. The patient should be treated symptomatically ie
If you do see the snake, look for as the symptoms arise.
these identifying points: 12. If however the snake has been killed, take it to the
hospital for identification.
21. Colour and Markings
22. Length – ruler or broomstick
long
23. Width – finger or wrist thick
24. Colour of belly
25. Shape of head
26. Long thin or Stubby tail
27. Reaction of the snake
28. Geographical area of the
snake
Rev. 02
Page 14 of 16
EMERGENCY CONTACT NUMBERS

ANTIVENOM/SERUM
AMBULANCE HOSPITAL
There are 2 types of serum for
snakebite:
SITE MANAGER
POLYVALENT – is a broad-spectrum
serum, used in most cases of
snakebite.
SAFETY OFFICER
MONOVALENT specifically
formulated for Boomslang bites
only
These serums are available from

the SAIMR (South African
Institute for Medical Research)
Tel: (011) 882-9940
13. Serum should be

administered ONLY in a hospital
environment.
14. For antivenom to have any

real effect, it should be
administered intravenously within
12 hours – depending variables.
15. Hyper-allergic people could

experience difficulty in breathing.
16. Antivenom is a horse-borne

serum and reactions to the serum
can be worse than the venom of
the snake.
17. Sea Snakes have a

combination of myotoxic (muscle-
attacking) and Neurotoxic venom
– bites are very rare and serum is
not usually available in South
Africa
18. Antivenom dosage is the

same for children and adults.
You cannot overdose on
antivenom.
2. 19. For Doctors: If

RESPONSIBILITIES:
administering serum for
neurotoxic bites, have adrenalin
& antihistamine ready drawn up.
Cortisone
Project only becomes
Manager, effective Engineering Manager, Production Manager, Production and
SHE Manager,
after few hours
Engineering & is notSupervisors,
Foreman, an Artisans, sub – contractors and all employees
emergency measure.
Rev. 02
Page 15 of 16
3. COMPLIANCE EVALUATION:
N/A
4. REVISION RECORD:
Record of Changes
Date Revision Changes made to this revision
31 November
1 New SOP
2008
Purpose
Scope
Document Owner
14 June 2012 2 Review Team
Description of process
Responsibilities
Review Period Expired
5. SUPPORTING DOCUMENTS:
Type of Record Owner Location Protection Retrieval Retention Disposal
Rev. 02
Page 16 of 16
6. TRAINING RECORDS:
Name & Surname Coy No. Occupation Signature Date

Sop OPOP - 048 - Snakes and Snake Bites

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Sop OPOP - 048 - Snakes and Snake Bites

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Systems Procedure OPOP 048

Responsible Department: OPOP

This procedure excludes the following:

Responsible Department: OPOP

1.2 Types of snakes that are poisonous

Responsible Department: OPOP

1.3 Appearance during season

1.4 General guides if bitten by a snake

 Immediate burning pain followed by swelling.

1.5 Prevention of snake bites

 Leave snakes alone

1.6 Snake bite symptoms

Responsible Department: OPOP

 Internal bleeding , blistering and death of tissue

1.7 Treatment of snake bites

Additional information: (1)

FIRST AID in SNAKEBITE:

Responsible Department: OPOP

Shock - How to Recognise and Treat

 Heavy or difficult breathing

Responsible Department: OPOP

The first aid of choice, in snakebite, is the pressure bandage

Responsible Department: OPOP

A VICTIM OF A PUFFADDER BITE TO THE

THE BANDAGE IS TAKEN

THE WIDE CREPE BANDAGE IS

THE SPLINT IS BOUND TO THE LIMB

Responsible Department: OPOP

THE LEG IS NOW

Responsible Department: OPOP

MEET THE VENOMOUS SNAKES OF THE PENINSULA

Naja Nivea - Cape Cobra, Geelkapel, Koperkapel.

Bitis Arietans - Puff adder, Pofadder

Responsible Department: OPOP

Dispholidus Typus – Boomslang

Additional information: (2)

Responsible Department: OPOP

SNAKEBITE STEP BY STEP

Responsible Department: OPOP

dehydration and secondary

IMPORTANT FACTS TO REMEMBER

Responsible Department: OPOP

Responsible Department: OPOP

EMERGENCY CONTACT NUMBERS

These serums are available from

13. Serum should be

14. For antivenom to have any

15. Hyper-allergic people could

16. Antivenom is a horse-borne

17. Sea Snakes have a

18. Antivenom dosage is the

2. 19. For Doctors: If

Responsible Department: OPOP

Responsible Department: OPOP

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