"Venom 1" Team Saves Snakebite Victims
Bijal P. Trivedi
National Geographic Today
|August 21, 2002|
One of the few civilian planes in the skies on September 12th was
carrying antivenin to treat a 62 year-old diabetic snake importer who
had been bitten on the 11th by a seven-foot Taipanan exotic from
New Guinea, and one of the world's most deadly snakes.
The job of treating the man fell into the hands of Captain Al Cruz, a firefighter and paramedic with Miami-Dade Fire Rescue Department and founder of its snakebite unit, "Venom 1." This is the only firefighting unit in the country equipped to deal with snakebites.
Lawrence van Sertima, the victim, had been handling snakes professionally since his early twenties in Guyana, where he grew up. While working in the Miami-based "hot room" of Zoological Imports 2000, Inc.where more than 250 venomous snakes were housedhe was bitten while returning the Taipan to its cage after administering medical care.
"It is the equivalent injury to a carpenter getting hit with hammer, maybe a bit more painfulthis job is risky and a bite comes with the territory," said van Sertima. "And this guy got me good."
"I left the hot room feeling dizzy, sat down, and within 10 to 15 minutes I just keeled over," he added.
Van Sertima was taken to Miami Baptist Hospital where he was kept breathing for 16 hours on a ventilator and given vial upon vial of antivenin. As the supply of antivenin dwindled and van Sertima showed no signs of recovery, Cruz called the reptile curator at the San Diego Zoo at 1:30 a.m. on September 12th, 2001this was the only other store of the antivenin in North America.
Then came the Federal Aviation Administration. By the wee hours of the morning, Cruz had convinced the director of the FAA to waive the flight ban, imposed after the terrorist attacks in New York and Washington, for an air ambulance delivery of antivenin to Miami. "The reason I am here today is because of Al Cruz," said Sertima.
Black Mamba Bite
Cruz founded the antivenin program serendipitously. In March 1998 a black mamba bit a snake handler, and no antivenin existed in any of the nearby hospitals. Cruz was contacted because of his reputation as an avid amateur herpetologist. By chance he knew someone who raised black mambas and had the antivenin, and was able to save the man's life. But the episode emphasized the need for a centralized antivenin bank. Cruz founded the Antivenin Program in July 1998.
Now the Miami-Dade Fire Rescue Antivenin Banka humble refrigerator containing 25 different antivenins for 95 percent of the world's venomous snakesis the most extensive in the U.S., said Cruz. Venom 1 provides antivenin to hospitals all over the Caribbean and eastern U.S. The bank has supplied antivenin as far north as Ontario, Canada, and as far south as French Guyana.
There are basically two antivenins for snakes native to the U.S.one for pit vipers and another for coral snakes. The rest of the antivenins are for exotic snakes imported from Europe, Asia, Africa, Australia, and South America. Venom 1 receives a cobra call about once every month to every six weeks.
There are approximately 8,000 venomous snakebites in the U.S. every year; 250 are in Florida.
"Since the operation began, we have handled about 400 bites without a single fatality, even though a dozen people stopped breathing before we had arrived with the venom," said Cruz.
No Two Bites Are Alike
In Florida, about 65 percent of these bites are "illegitimate"that is, they occurred while deliberately handling the snake. The other "legitimate bites" are endured while hunting, fishing, camping, and engaging in other outdoor activities. Curiously, the majority of bite victims are males between 20 and 36, Cruz said.
But even when it comes to venomous snakes, not all bites are deadly. About 30 percent of all bites are drythat is, little or no toxin was injected. "Snakes can control the amount of venom they inject. For example, they can take three to four weeks to regenerate their venom stores if they have just killed prey," said Cruz. A bite from a snake in this condition could be dry. A hungry or angry snake is a different matter.
"As far as U.S. snakes are concerned, you have an average of about two hours before a bite becomes life threatening," said Cruz. "The trick is not to get agitated. Think of the bite as a broken bone and try to keep it immobilized and away from the heart."
"Everything you've seen in the movies, everything John Wayne used to dodon't do. Don't cut, suck, or ice the bite. Don't tie a tourniquetall of these things just cause problems."
The problems caused by snakebites are as diverse as the snakes themselves. "No snakebites are the samethey depend on the species, the size, the age, and the snake's state of mind," said Dr. Roberto R. Del Cristo, a doctor of internal medicine and medical director of the Antivenin Bank.
Venom is a complex cocktail of at least 20 to 30 compounds each destroying different parts of the body, said Del Cristo. Hemotoxins attack the tissues and circulatory system, destroying blood-clotting agents, causing uncontrollable bleeding in the brain, eyes, and kidneys. They also digest tissue causing irreversible damage. Neurotoxins target the nervous system, paralyzing the muscles, leading to heart failure and suffocation.
With all the fear that snakes evoke, there are only about 15 fatalities per year, according to statistics from the University of Florida. "The trick is to remain calm," said Del Cristo. "We recently had a wonderful case where a 21 year old was bitten by his pet cobra, totally paralyzed and on a ventilator. But a few hours after the antivenin was given he was demanding food, and a day later he walked out of here."
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