About the bites of poisonous snakes and spiders
Participants in the current events in the Donbass began to worry about the problems associated with possible bites of poisonous snakes.
Many volunteers are trying to provide the defenders of Ukraine with a "panacea" - anti-snake serum; fear of snakes prevents one of the participants from solving assigned tasks.
Here are: firstly, a fairly detailed description of dangerous and non-dangerous snakes; secondly, an explanation of what to do with a snakebite; thirdly, information about karakurt and their bites, and, finally, a short squeeze from the verbose part of the text.
Poisonous and non-poisonous snakes
Steppe viper in images with varying degrees of detail. That it should be feared by the participants of the ATO
ATO participants and those responsible for their health began to worry about the possibility of snake bites. This was to be expected: 2014 was a “mouse year” (with a high number of mouse-like rodents), and in 2015 the number of vipers increased sharply. It is the vipers that are the only snakes in Ukraine that pose a danger to humans. They inhabit almost the entire territory of the country. Simplifying somewhat, it can be said that the ordinary viper (Vipera berus) lives in Polesie, the Nikolsky viper (Vipera nikolskii) in the Forest-Steppe, and the steppe viper (Vipera renardi, the older name is Vipera ursinii) in the Steppe. All the rest, except for vipers, snakes of Ukraine are not dangerous to humans (at least in terms of their toxicity). It is important to emphasize that the steppe viper and Nikolsky viper are listed in the Red Book of Ukraine. The use of their habitats by law should be strictly regulated, their destruction is prohibited (and punishable by fines). This is quite natural; for example, the steppe ecosystem is an interconnected whole, and the steppe viper is an important part of it.
Thus, the only dangerous snake in the steppe areas of Donetsk and Lugansk regions is the steppe viper. This is a small (length with a tail not exceeding 65 cm), not very mobile snake with a very characteristic appearance. Dark spots are scattered on the light background of her body, which often line up in a zigzag pattern. Young vipers feed on insects, then lizards. The main food of adult vipers is mouse-like rodents and small birds. If the weather is cool enough, it is more likely to meet an adder in well-warmed places; in the heat, vipers carry the peak of their activity for a less hot time. They hunt mainly at night, sitting in ambush near those places where there are many chances to meet the victim. The viper bites the mouse, injects poison into it and immediately releases it. The smell of a bitten mouse changes. The viper will follow the smell track, find and eat a mouse, which is already digested from the inside by the poison introduced into it during a bite. From what has been said, there follows a recommendation on how to reduce the chances of encountering an adder: where people are, there should be as few mice as possible. To reduce the number of mice, you should remove accessible human food and its remains, as well as clean the shelter in which the mice can hide. By the way, this is very useful from an epidemiological point of view.
In the forest-steppe areas along the Seversky Donets, one can meet another type of viper - the Nikolsky viper. It differs from the other two of our species in coal black. And in Polesie there is an ordinary viper with a rather diverse color, but an inevitable "viper" appearance. All our vipers are small, not very mobile, rather thick snakes. Their heads are expanded posteriorly, the posterior half of the head is covered with scales, rather than large shields.
Two color options for the common viper (left and middle) and the Nikolsky viper (right)
The local population of southern Ukraine is often afraid of yellow-bellied or Caspian snake (Dolichophys caspius). This is a large and mobile snake, which sometimes reaches 2.5 meters. Its color is monophonic (blurry spots are visible in young individuals). The yellow-bellied snake is practically the only snake in Ukraine that can attack a person “on its own initiative”; it bends with a spring and makes sharp lunges, sometimes biting in the face. Such an attack makes a strong impression on a person, and after a sharp attack, the yellow-bellied snake has time to safely hide. His bite is safe; minimal damage to the skin caused by his short thin teeth can be neglected. Stories about one and a half meter vipers, "cobras" in the south of Ukraine (which turn out to be Caspian snakes), fears of coppers and other harmless snakes are simply connected with the illiteracy of people and with the wonderful property of snakes to wake up the game of imagination.
And this is the only snake in Ukraine, which can attack a person herself, yellow-bellied snake. In the case of his bite, you do not need to do anything (well, you can sanitize the wounds to cleanse your conscience)
Probably the most common snake in southern Ukraine is the water snake (Natrix tessellata). This is a near-water snake specialized in feeding fish. Its coloring is very variable. A typical case is that darker spots are scattered in a checkerboard pattern on a dark or light brown or sand background; monophonic and even almost black water snakes are found. Stories about snakes that swim in the water (and even more so - eat fish and bring ashore fish caught in the water) snakes - these are stories about water snakes. Vipers can swim, but rarely enter the water (especially the steppe vipers) and try to get out of there quickly.
All of these are water snakes. They are completely harmless!
How to avoid a viper bite?
In itself, an adder will not attack a person under any circumstances. Alas, this snake is not very mobile, and it may be in a situation where a person will pose a real or apparent threat to it. In this case, it will be protected by a bite. In order not to suffer from a bite of a viper, where snakes can be - do not walk barefoot, look under your feet, do not pick up objects on the ground, in grass, bushes.
High boots, loose clothing made of thick fabric, gloves made of thick leather reliably protect against an accidental bite of a viper (and from many other troubles, like thorns and stinging insects).
If you meet a viper, it just needs to be given the opportunity to get out. If the viper is in your way, you can just stomp your foot on the ground and it will try to hide. In the most extreme case, the viper can be picked up with a stick (at least half a meter) and thrown to the side.
The action of snake venom and the relief of the state of a bitten
The active substances of snake venom are proteins. These are several different toxins, the task of which is to ensure that the poison enters the bloodstream and cause a destructive reaction for the victim’s body. A significant part of the pathological symptoms of a viper bite is associated with the work of their own protective systems of a bitten organism. Without going into details, reactions to a bite can be divided into local and systemic (general). Among the local ones is the defeat and death of tissues at the site of the bite, the development of edema. Blood plasma comes out of the bloodstream, blood thickens, blood cells can be destroyed, and the likelihood of blood clots increases sharply. There are regulatory substances that contribute to the development of a protective reaction, of which histamine is the most important. Its sharp selection significantly worsens the overall picture. The volume of circulating blood decreases, heart failure develops. It is important to emphasize that in the event that an adder living in Ukraine bites an adult, the bite was not applied to the head or neck and there are no aggravating circumstances (like "folk" methods of treatment - cauterization, dissection, tug of war, etc.), life threatening bitten is practically absent. However, this is a rather serious disease that requires specific treatment.
If the bite is made through clothing, you need to free the bite and remove drops of poison that can be on the clothes and skin.
Immediately after the bite, it is advisable to start draining the poison from the wound left by the snake teeth. It is indicated that quick and proper suction can remove 40%, or even more of the dose received. The poison can be sucked out by mouth, often spitting and rinsing the mouth with water; in the presence of wounds in the mouth, aspiration of poison is undesirable. There are special devices for draining the poison, but most likely they will not be at hand. You can suck out the poison with an ordinary plastic syringe, the front of which is evenly cut with a knife so that it fits snugly around the skin around the bite. After the onset of edema, or after 5-15 minutes, the exhaustion should be stopped (the poison had already spread quite widely by this time). Given future swelling rings, bracelets, watches, etc. with a bitten limb should be removed. Massage of the bite site and its mobility should be minimized (during the exhaustion of the poison, you can massage the bitten area towards the wound).
It should not be categorically: make cuts at the site of the bite, burn it with hot objects, apply cold, apply pressure dressings. All these actions will aggravate local tissue damage, lead to large areas of tissue death, poisoning of the body by decay products and other troubles. The belief that the clinical picture is facilitated by alcoholic drinks is also harmful (of course, you can pump up to insensibility, but this will only aggravate the viper’s venom). After exhaustion (or without it) you just need to disinfect the bite site with some of the antiseptics, cover it with a clean cloth and try to keep it calm and cool. You can impose a splint on the affected limb to immobilize it and reduce lymphatic outflow (with which poison is carried throughout the body). It is important to do this so as not to overtighten the swelling limb, which can lead to pain and local lesions. Ultimately, the tissues at the bite site will try to bind the snake venom proteins and fight for their survival.
Evgeny Komarovsky (in the video, which is lower, after the 12th minute) advises bandaging a bitten limb to reduce lymph outflow. A bitten limb should be below head level.
It is significant that a panic or simply excited state of a bitten person significantly worsens his condition. The bitten one must be explained that there is no threat to his life; unfortunately, he ran into trouble, and after that his task was to lie relaxed in a cool place, drink more, urinate often, doze more and wait quietly until his body copes with the consequences of snake venom damage. Unfortunately, myths about the "terrible power of snake venom" interfere with this. Keep in mind that the bite of even the most terrible species of snakes that lived in the USSR or in Afghanistan, such as, for example, gyurza (Macrovipera lebetina), was not a death sentence at all. With a bite of a gyurza, 85% of the survivors survived without any treatment. Snakes, from which the majority of those bitten die, are found only in the tropics of Eurasia and on other continents; snakes whose bite would leave no chance of survival does not exist. As for the vipers of our country, the deaths of adults from their bite (and not from the barbaric methods of "treatment") are generally unknown.
An important question is whether to use anti-snake serum? If the bitten person gets to the hospital, where there will be an opportunity to introduce her, he will receive it almost certainly. The fact is that a typical doctor is afraid of "not getting enough" and not doing something that he could, in a state where the patient is in danger. If there is serum, it will be administered in the case when there are indications for its introduction, and when there are none (so that the doctor would not have to make excuses later that he did not do everything he could). Serum is an antibody (immune protein) of a horse that has been injected with snake venom. These antibodies recognize specific proteins of the poison and bind to them in complexes, which are then absorbed by protective cells. But, anyway, the introduction of serum is the introduction of a bitten significant amounts of foreign protein. This protein can cause an acute reaction up to anaphylactic shock (a deadly condition that requires resuscitation procedures and difficult treatment). In fact, serum binds snake venom, but in some respects it can trigger similar (and even more acute) reactions of the patient's body. If a bite is life threatening, all remedies are good, including serum; if there is no threat to life (and also in the case when qualified medical care and a sufficiently long observation in the hospital are unlikely or impossible), it is better to do without serum.
There is one difficulty in what has been said. The decision to refuse some medical actions can be made either by a very qualified doctor, or by the patient himself. If there is an opportunity to introduce serum and ensure normal monitoring in the hospital, perhaps you should agree with the doctor who suggests doing this. However, when the author of these lines in the Donetsk region was bitten by a steppe viper, he initially refused hospitalization and was treated on his own, and then when (at the insistence of the director of the reserve in which this happened) he nevertheless got to the hospital, he withstood the pressure of the doctors and signed up that voluntarily refuses the introduction of serum. It was not necessary to regret it. In a war situation or threat thereof, qualified medical assistance may not be available. In such conditions, if there is no threat to life, the rejection of serum is possible and probably justified.
And how to alleviate the condition of the bitten?
To alleviate the condition of the patient, antihistamines are very important. In the case of a viper bite, the maximum single dose allowed for this drug should be taken. Dr. Komarovsky advises loratadine or cetirizine . You can use other drugs. For example, if we are talking about diazolin tablets containing 100 mg of the active substance, the maximum single dose of this drug is 300 mg, and the maximum daily dose is 600 mg, then immediately after a bite 3 tablets should be taken, and then, after 8, 16 and 24 hours - another pill.
The administration of a hormonal anti-inflammatory drug can alleviate the condition. Dr. Komarovsky advises dexamethasone . Finally, after a bite, it is useful to drink plenty of fluids, preferably so that you sweat (do not drink through force, but the flow of fluid should be sufficient and plentiful). A significant intake of water will improve the condition of the blood and lead to increased work of the kidneys (and sweat glands), which contribute to the self-purification of body fluids. You can drink tea, or you can also appropriate saline solutions (like rehydron ).
Previously, a patient bitten by a snake was recommended to administer intravenously calcium chloride (as a means of increasing the resistance of blood cells) and magnesia (as a remedy for heart failure). Dr. Komarovsky argues that now these measures can be considered irrelevant. All other actions that must be performed with a bite are simply symptomatic treatment, which should alleviate his condition. Taking painkillers (like paracetamol) is undesirable.
Are the measures described here sufficient?
For many volunteers, it seems that by taking an ampoule of imported anti-snake serum, they will save the life of a fighter. In fact, the method described here has been repeatedly tested by professionals who work with snakes (and somewhat modified in accordance with the advice of the modern emergency medinas). It is quite sufficient for cases of a bite of a healthy man by an viper in the leg or arm. If the bitten gets to the hospital, he will be treated differently. They will introduce serum (at least for the sake of reinsurance), but they will also monitor the state of the cardiovascular system more professionally and conduct symptomatic treatment better. If there is an opportunity to lie in the hospital - you can go for it, if not - it is easier to use the experience of professionals who use the measures described and remain healthy.
Poison Spiders and Their Bites
Karakurt and his hole
No less important problem than poisonous snakes, for participants in ATO can become poisonous spiders, or rather - one of their most dangerous species. This is karakurt ( Latrodectus tredecimguttatus ). A karakurt bite is no less dangerous than a viper bite; all other spiders of Ukraine, if they can bite through the skin, are not more dangerous than wasps and bees.
In general, karakurt looks rather ominous: it is a rounded black spider, on the abdomen of which there may be small red or white marks. The female is larger than the male (1-2 centimeters); only she poses a significant danger. Karakurt is a settled spider. Its web is located in secluded places, in the burrows of rodents and depressions of the soil. In mid-summer heat, spiders can move around, looking for a new place (and just looking for coolness). In such a situation, they can crawl into the folds of clothes lying on the ground, in tents and in other places where they can come into contact with a person.
How to avoid a bite of a karakurt?
Clothing and shoes lying on the ground in the accessibility of spiders should be inspected before donning; the mosquito cover of the tent must be buttoned up. When moving along steppe and desert areas, attention should be paid to small spider webs in the indentations of the earth and on small slopes. Sitting down and lying on the ground should be inspected as far as possible. Fumble with unprotected hands in those places where there may be karakurt is very dangerous. If you find a spider on yourself, you should not try to crush it (bite!); it must be carefully discarded with a sharp movement. In those situations where body contact with the surface of the soil and thickets of grass is inevitable, it is necessary to protect the skin with dense clothing.
The poison of karakurt is neurotoxic; local phenomena with a bite are mild, but systemic manifestations can be quite serious. The consequences of the bite of this spider are characterized by severe pain, deterioration of well-being, up to and including loss of consciousness and delirium. General weakness, as a result of the consequences of a bite, can persist for up to a month (that is, much more than after a viper bite). When bitten by a karakurt, the poison is injected into the skin to a shallow depth (up to 0.5 mm). In accordance with this, the following remedy is recommended: within 1-2 minutes, press the head of the match (or three matches) to the bite site, and light them from the burning match, continuing to press them to the skin . Believe me, this tool does not require any heroism (the author tried it!). You can also burn the bite of a burning cigarette. After 2 minutes, these actions lose their meaning (the poison has time to spread).
Unlike snake bites, when you bite a karakurt, you can use anesthesia with paracetamol or ibuprofen, you can apply cold. The rest is like a snakebite. Immobilization (bandaging possible) of the limb. Drink plenty. Antihistamines ( loratadine or cetirizine ). Hormonal anti-inflammatory drug ( dexamethasone ).
Unfortunately, after a bite of a karakurt (especially if neutralization of the poison was not carried out with a shallow burn), adverse symptoms from the cardiovascular system are possible. The author does not feel entitled to describe those therapeutic actions that should be performed in such a situation. Bitten by a karakurt, if he still has an unfavorable condition (for example, heart failure), it is advisable to deliver it to the doctor who will carry out the necessary symptomatic treatment.
If you have to work or fight in the steppes of southern Ukraine, figure out what the steppe viper looks like: a small clumsy snake with a dark zigzag on a lighter background. In the forest-steppe you can meet the coal-black viper Nikolsky. They do not need to be afraid, but you need to protect yourself from their bites. Protect yourself with tight clothes, shoes, gloves. To reduce the chance of encountering vipers, do not bring mice to your place of residence.
In case of a viper bite: suck out the poison with the mouth (rinsing the mouth with water and spitting) or with a syringe. To immobilize a limb, removing what can transmit it; can be gently bandaged. Do not cauterize, do not cut, do not drink alcohol and painkillers! Take an antihistamine (loratadine, cetirizine, etc.), a hormonal anti-inflammatory drug (dexamethosone). To a bitten one - to lie alone, not to be afraid of anything, not to move the affected limb, to drink plenty of water (rehydron solution, tea ...). In the future - symptomatic treatment, with serious problems with cardiac activity - see a doctor.
In the steppe, especially in the heat, beware of karakurt! These are black spiders with a rounded body, on which there may be white or red marks. Take a closer look at secluded places revealing a web; Inspect clothing and shoes that the spider could crawl into; button the tent canopy. Use tight clothing.
When biting a karakurt, cauterize the bite site no later than 2 minutes later! Press 1, 2, or 3 match heads to your skin and set them on fire. Take an antihistamine (loratadine, cetirizine, etc.), a hormonal anti-inflammatory drug (dexamethosone), you can take pain medication (paracetamol, ibuprofen). To a bitten one - to lie alone, not to be afraid of anything, not to move the affected limb, to drink plenty of water (rehydron solution, tea ...). In the future - symptomatic treatment, with serious problems with cardiac activity - see a doctor.
Carry an antihistamine (useful in many cases), such as loratadine or cetirizine, and a hormonal anti-inflammatory drug, such as dexamethasone, as well as a syringe, matches, and saline (rehydron). Always carry matches with you!
Good luck and health!