Snake Bites – It could be YOU! It is a hot & humid summer day in August. You are out in the woods riding with your favorite buddy, at least an hour from the trailhead, and have not seen another person since you started your ride. On a difficult rocky climb, you suddenly snap your chain, and it is lying on the ground. You turn the bike upside down on the trail to start the chain repair, your friend stops to help, and you start to repair the chain. Before you finish, your friend hears a funny cicada like noise just a few feet away and yells a warning to you – IT IS A TIMBER RATTLESNAKE! If he had not heeded the warning from it’s rattle, you could have easily stepped on the snake as you were focused on the chain repair, or put your hand down behind you on the snake as you were crouching on the ground. Luckily, the rattler quietly retreated from the spot, and the snake ignored you and slowly slithered away across the trail... WHAT DO YOU DO IF YOU GET A VENEMOUS SNAKE BITE??? Some common venomous snakes in the US include the Coral snake, Timber Rattlesnake, Copperheads, Water Moccasins and the Eastern Diamondback Rattlesnake. Painful but non-lethal bites can be inflicted by water moccasins or copperheads. Most of these snakes will only bite if threatened or stepped on, and certainly do not attack humans unless they are unseen and you contact them without knowing it – like if they get into your pack or bedding, or if you step on them. Snake venom if a complex mixture of enzymes, polypeptides, glycoproteins, and metal ions. Among the deleterious components are hemorrhagins that promote vascular local and systemic bleeding. Proteolytic enzymes cause local tissue necrosis, affect the coagulation pathway, and impair organ function. The Coral snake bite may also involve respiratory problems as it may contain neurotoxins. Other bites may also cause myocardial depression and affect the heart rate, and neurotoxins act to inhibit neural impulses. Rattlesnake bites mostly have cytolytic toxins which cause tissue destruction, local pain, redness, swelling, and bleeding. Tingling around the mouth, metallic taste, nausea, vomiting, and hypotension may also occur. It is also possible in about 20% of bites that no venom is released - in which case you have a "dry" bite, which is certainly a lot better!! HERE IS WHAT YOU DO IF YOU ARE A VICTIM… *Pull off the snake asap *Try to identfy the snake or kill it if possible so that medical personnel can make a positive identification *Note the time - the progress of symptoms and swelling is the most obviuos indicator of the degree of envenomation *Remain calm (as usually there is an excellent chance of survival) - remove any jewelry in case of swelling *Immobilize the patient and the bitten part in a neutral position. Keep the wound lower than the heart. *Wash the wound with soap and water or rinse with energy drink *Avoid manipulation of the bitten area. *Monitor vital signs *Call for help with your cell phone if available or dial 911 *Transport the patient to a medical facility asap. *Do NOT give alcoholic beverages or stimulants; do NOT apply ice; do not apply a tight tourniquet. The trauma to underlying structures resulting from incision and suction by unskilled persons is probably not justified in view of the small amount of venom that can be removed. Do NOT use the old “boy scout” technique of cutting the wound, sucking out the venom, and then applying the tight tourniquet to the area. *If you can not get medical care within 30 minutes - you may want to apply a light bandage 2 inches above the bite to slow the venom and gently suck out any venom from the area *You need to focus on rapidly delivering the victim to definitive medical care – even though it may be several hours away. Use a cell phone if you have one – call 911, the local ranger station, and the local hospital, or send someone back for help. If you can’t do this, you have to decide whether to stay with the victim and try to transport him or go and get help while leaving him alone – a tough decision… *Keep the victim as inactive as possible (no riding!) to limit the systemic spread of the venom. *Mouth suction should be avoided as it inoculates the wound with oral flora and can also result in absorption of venom by the rescuer by the upper digestive tract. A medical device for suction called an “extractor” can be used if available within 3-5 minutes of the bite – the chance of having one of these is slim, however. *If the victim is more than 60 minutes from medical care, a proximal lympho-occlusive band may limit the spread of venom if applied within 30 minutes, but do not tighten it so much that it interrupts arterial blood flow – so a loose tourniquet IS recommended according to some sources. *The bitten extremity should also be splinted if possible and kept at heart level. Do not incise or cool the bite area with ice. *Get the victim to the nearest hospital, and call ahead when possible to inform them you are bringing in a snake bite victim. They will administer the appropriate anti-venom and perform the necessary care to minimize any danger to life or limb. The overall mortality rate for venomous snakebites are low in areas with rapid access to medical care and anti-venom. In the US the overall mortality rate is <1% from victims who receive anti-venom and proper medical care. Eastern and Western Diamondback Rattlesnakes are responsible for most snakebite deaths in the US. The incidence of morbidity in terms of permanent functional loss in a bitten extremity is substantial. This may result due to muscle, nerve, or vascular injury. In the US, such loss seems to be more common and severe after rattlesnake bites than after bites by copperheads and water moccasins. Here are some additional links whmentors.org xmission.com umm.edu |
