A highly venomous coral reef snake encounters a fisher. I explain his case with the symptoms, neurotoxicity, and treatments including the administration of antivenom.
00:00 Sea Snake Bite
00:42 Local Symptoms
01:04 Neurotoxicity mechanism
01:23 Systemic Effects
02:11 Place for Antivenom
02:21 What happened to the Snake
The angry waves are not the only danger a fisherman has to face. The Ocean is home to the most abundant venomous reptile on earth, The Sea Snake. On a fateful morning, one fisherman put his hands in the sea to collect the fishnet he had laid the night before. Unfortunately for him- a Coral reef snake trapped in the net bit his hand. The panicked fisherman caught the snake and brought it to the hospital with him.
The fate of both the fisherman and the snake were now in our hands! Will the fisherman and the snake survive? Find out today on tiny Medicine.
We didn’t treat the fisherman with antivenom. In the next minute of the video, you’ll learn why.
The patient complained of mild pain, swelling, and numbness at the bite site. We knew that more than the local changes at the bite site, we had to keep an eye on the systemic effects of the toxins. Initial systemic signs are nausea, vomiting, abdominal pain, and dizziness.
But the most feared complication of sea-snakes bite is neuro-toxicity.
• The nerves meet muscles at Neuro-Muscular Junction.
• Acetylcholine released by the nerve ends binds to the Receptors at the muscle membranes to initiate contraction.
• The sea-snake toxins bind to these exact receptors and acetylcholine-mediated muscle activation.
• This results in muscle paralysis.
• Muscle paralysis begins with eye muscles.
• Drooping of eyelids or Ptosis, and Double vision or diplopia, are the resulting symptoms.
• Then the muscle paralysis descends to the throat muscles-resulting in difficulty in swallowing and difficulty in speech.
• Generalized muscle weakness is a late symptom.
• If the respiratory muscles are paralyzed, the patient can develop fatal respiratory failure.
• We observed the patient for these signs. Thankfully, he did not develop any of the systemic signs.
So why didn’t we give the anti-venom?
Antivenoms for snake bites are highly allergenic. Sometimes it can cause anaphylaxis, a life-threatening allergic reaction. Since our fisherman didn’t develop systemic toxicity, we were able to monitor him without administrating the antivenom.
Rare systemic effects of sea snake toxins include direct muscle toxicity, rhabdomyolysis, renal failure, and coagulopathy.
Alright! So what happened to the snake?
-) Most sea snakes are seen in the Indian and Pacific oceans.
-) All sea snakes are poisonous and have paddle-like tails.
-) The presence of scales and lack of fins and gills help to differentiate coral reef snakes from eels.
-) The subject of our story happened to be a yellow-bellied sea snake. It belongs to the sub-family- hydrophiidae, which is the most common sea-snakes family. The other sub-family is Laticaudinae.
-) The sea snakes play dead when they are threatened. But after a while, our friend started to move. We consulted zoologists and released the snake back to the ocean according to their instructions.
We were able to save two lives that day. Interesting; right?
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