IL MORSO DELLA VIPERA.
Con le belle giornate in arrivo e il sole che dovrebbe ormai far capolino, è normale incontrare sui sentieri o in giardini e orti dei serpenti. Alcuni, in genere la maggior parte di essi, in caso di attacco, sono innocui, ovvero non sono velenosi per l’uomo; altri, invece, potrebbero creare problemi se dovessero mordere. Nei nostri territori parliamo di vipere. Una cosa da sapere è che la vipera non sempre inocula il veleno: in almeno il 30% dei casi il morso è “secco”; e nel caso dovesse essere inoculato, non sempre la dose iniettata risulta tossica e quasi mai mortale. Il veleno genera segni e sintomi locali che compaiono entro pochi minuti: gonfiore, eritema o arrossamento, dolore locale ed ecchimosi, dovuti al danno tissutale locale e dell’endotelio. Se il dolore locale non compare entro tre ore, si può escludere l’intossicazione. I sintomi sistemici, invece, possono esordire dopo alcune ore, ma di solito si manifestano appieno entro 24 ore dal morso e possono essere: nausea, vomito, diarrea, crampi addominali, dolori muscolari e/o articolari, abbassamento della pressione arteriosa, senso di vertigine e turbe a carico del sistema nervoso. I soggetti a rischio importante sono i bambini, gli anziani e le persone con patologie debilitanti. Come capire se siamo stati morsi da una vipera? Il morso di vipera è caratterizzato dalla presenza di dolore locale, gonfiore, piccole vesciche emorragiche e i tipici segni lasciati dai denti veleniferi, distanti dai 8 ai 10 mm tra loro, a differenza delle serpi non velenose che lasciano un segno molto meno evidente. Se non si è in grado di riconoscere con che tipo di serpente abbiamo a che fare, non perdiamo tempo a catturare o cercare di capire se è una vipera, se avrete la peggio l’impronta che lascia il morso è il segno più chiaro per intervenire nel modo giusto.
Cosa fare in caso di morso?
È fondamentale mantenere la calma e seguire due obiettivi:
- Supportare le funzioni vitali (BLS) se necessario;
- Far arrivare il paziente in ospedale nel minor tempo possibile evitando/rallentando la diffusione del veleno.
Quindi, tranquillizzare la vittima. La zona del morso deve essere accuratamente lavata e disinfettata, non usate alcool, peggiorerebbe la situazione. Rimuovere anelli, orologi, bracciali, per evitare che possano rimanere incastrati in caso di gonfiore. Per rallentare la diffusione del veleno, si dovrebbe procedere all’applicazione di un bendaggio linfostatico e di seguito immobilizzare l’arto dov’è il morso. Comprimere la zona colpita nel caso il morso sia localizzato al collo, al capo oppure al torace. In ultimo, procedere all’immediato trasporto in ospedale. L’infortunato dovrebbe non muoversi per evitare che il veleno possa diffondersi in circolo più velocemente. Attenzione, ansia e panico sono più pericolosi del morso stesso. Se adulti e in buona salute e se non siamo soggetti allergici, il morso dei nostri serpenti non è mortale.
Cosa non fare in caso di morso?
Non si deve assolutamente incidere la cute nella sede del morso; non applicare assolutamente un laccio emostatico; né si deve effettuare una suzione del veleno. Non si deve iniettare siero antivipera al di fuori dell’ambiente ospedaliero, sia perché il siero si inattiva rapidamente dopo alcune ore a temperatura ambiente, sia per il rischio di shock anafilattico. Inoltre, non somministrare alcoolici dato che hanno un effetto depressivo sul sistema nervoso ed essendo vasodilatatori periferici favoriscono l’assorbimento del veleno più velocemente.
Come è possibile prevenire il morso di vipera?
Calzare scarpe alte da montagna, indossare calzettoni al ginocchio o pantaloni lunghi; utilizzare un bastone per battere il sentiero, le vibrazioni prodotte sul terreno da quest’ultimo e dai nostri passi faranno scappare le vipere; evitare di sedersi su pietraie e sassi e non infilare le mani in cavità di alberi o altri buchi. Ricordate che il primo e l’ultimo sole sono i momenti in cui questi animali vanno in giro. Nelle ore più calde invece sono rintanate al fresco.
E cosa fare se ad essere morso è il proprio cane?
Mantenete prima di tutto la calma voi e cercate di tranquillizzare il vostro amico. Il primo soccorso è uguale a quello descritto in precedenza. Portatelo in seguito immediatamente da un veterinario, tenendolo in braccio o nello zaino, così da non farlo camminare o fare sforzi.
Ci sono in commercio svariate proposte di kit antivipera che contengono strumenti che non devono essere utilizzati in un primo soccorso corretto. Gli unici presidi che servono sono: dell’acqua, un buon disinfettante, una benda elastica e tanta calma. E perché no il nostro corso di Primo Soccorso, se non altro per imparare bene il bendaggio linfostatico. Nel caso di dubbi sono a disposizione i centri antiveleni che possono essere contattati per ricevere supporto telefonico anche in loco dalla vittima.
Milano Niguarda (24 ore su 24 7 giorni su 7) Tel: +39 02 6610 1029
Roma Gemelli (24 ore su 24 7 giorni su 7) Tel: +39 06 3054 343
Napoli Cardarelli (24 ore su 24 7 giorni su 7) Tel: +39 081 7472870
Come sempre, il primo soccorso non si improvvisa. Meglio non fare che fare male. È molto importante non effettuare interventi che potrebbero aggravare la condizione dell’infortunato, se non delegati dal medico della Centrale Operativa Territoriale 1.1.8. Intanto, come sempre, Vi invito a frequentare i nostri Corsi di Primo Soccorso e Manovre Salvavita per imparare le tecniche e le procedure corrette. Alla prossima.
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