Getting to know the local killer wildlife

By Private John Wellfare

Banda Aceh and Nias snakebite protocol

ALTHOUGH Australians tend to be familiar with the types of snakes they’re likely to encounter in this country, the species, symptoms and treatment can vary in other parts of the world.

The task of preparing medical staff for the different snakebite threat they’re likely to encounter overseas is entrusted to Lieutenant Colonel Geoff Newman-Martin, a specialist in toxinology with Defence Health Service Branch’s Directorate of Preventative Health. In partnership with Associate Professor Julian White from the University of Adelaide, Australia’s foremost clinical toxinologist, Lieutenant Colonel Newman-Martin developed a medical protocol for snakes and snakebite in Banda Aceh and Nias, Indonesia.

Although Australians spent only a short time in the region, developing the protocol has provided valuable groundwork for other areas, as many of the snakes found in Banda Aceh and Nias inhabit the whole Indonesian Archipelago and the Malaysian Peninsula, Lieutenant Colonel Newman-Martin says.

“It’s become a bit of a source document for developing evaluations for other areas,” he says. “We have actually used many of the principles involved [in the Aceh/Nias protocol] for other studies.”

There was no secret to the work involved in developing the study, he says, it’s all about research.

“Essentially you have to find out what occurs there, which involves basically knowing your subject, knowing which sources to look up, which to cross check against each other – which not to – and also working out which of them is likely to present a serious health hazard and which are not.

“Finally, it boils down to working out which types are going to require antivenoms if people are bitten, or if there are antivenoms for them because in some cases there aren’t any.”

Australia is one of the best prepared countries in the world when it comes to dealing with snakebite. Antivenoms have been produced for every type of Australian snake and hospitals are equipped with a venom detection kit, which helps medical staff quickly identify the snake and administer the right antivenom.

Overseas, with a different variety of snakes not supported by the venom detection kit, snakes can often only be identified visually at the time of the bite.

“Australia’s fairly unique in that the types of dangerously venomous snakes we have here are all front fanged, so-called ‘elapid’ snakes,” Lieutenant Colonel Newman-Martin says. “Overseas they have a mixture of cobras, vipers, asps and snake types that we don’t have here, that produce quite different effects.”

The specific regional protocols, which, for long term operations, would be distributed to medical personnel before deploying as a guide on that area’s specific threats, give details on the different species of snake, identifying bite marks and symptoms, availability of antivenom, first aid and treatment for bite victims.

“Those of us who are in this field are constantly combing the internet, constantly combing the medical literature, the scientific literature and the text books to see what we can pull out of it.

“In Australia, we only have about four deaths per year due to snakebite. That’s mainly because of a very good medical system, excellent transport, the fact we have all the antivenoms and the venom detection kit, also that we have a very effective first aid technique and good communications in this country.

“When we send troops overseas, we identify health threats, which give us a picture of what dangers our troops are likely to encounter.”

The Banda Aceh and Nias snakebite protocol is available from the Defence Health Service website.

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