Health Care and Snake Bites

Who doesn't fear snakes? Fear of snakes for their venom is rational fear...a healthy respect for the danger some snakes represent, according to Way2Hope.org. Ophidiophobia is irrational fear of all snakes...those on the ground, in a cage, on TV, even in your imagination. When the anxiety is extreme, irrational, even to panic attacks or disability, it has moved from fear to phobia. While many think fear of snakes stems from some childhood experience, there is some evidence that other causes may exist. The snake is a Biblical symbol of evil, which may tend to heighten the fear in some. Of course, the many snake attacks in TV and movies only add to the anxiety of some.

According to SurviveOutdoors.com, since Adam and Eve snakes have long been portrayed as evil creatures to be feared. Our history is long, and myths and phobias are hard to break. Built into their religious practice, Pentecostal Movement preachers in the hills of Tennessee handle rattlesnakes. They now struggle with local law enforcement since rattlesnakes are protected in many states. Aboriginal groups in Australia hold the snake in high esteem, and it is a symbol of fertility. Native Americans felt that snakes symbolized life cycles and truth. There are widespread myths regarding snakes:
--Snakes hold their tails in their mouths to create a circle and will chase you.
--When you kill a snake, another one will chase you (ironically, what IS true is excessive killing of snakes leads to the overpopulation of rodents and more disease states).

There are two types of venomous snakes, falling into two separate categories, the pit vipers which include the rattlesnakes, copperheads and coppermouths, and the elapids, which are coral snakes, according to Survive Outdoors. Due to the internet, more and more exotic/foreign snakes are being brought into the United States illegally. This is an extremely dangerous practice, posing enormous diagnostic and treatment risk for emergency rooms across the United States. Every month, there are incidents that occur where someone is tired of their exotic and most likely illegally owned pet and releases it, or possibly it escapes. Here are some facts about snake bites:
--In the United States, only about 12 people a year die from snakebites.
--The estimated chances of dying from a snakebite in the outdoors is approximately 1:10 million. --Victims of snakebites in North America usually have two common denominators, tattoos and alcohol intake.
--There are approximately 23 different subspecies of rattlesnakes in the United States including the coral snake, copperhead and cottonmouth (or water moccasin), which comprise the venomous snakes indigenous to the United States.

However, snake bites of any kind are dangerous. Each year, nearly 8,000 people receive poisonous snake bites in the United States, according to the University of Maryland Medical Center (UMMC). Even a bite from a so-called "harmless" snake can cause infection or allergic reaction in some people. People who frequently visit wilderness areas, camp, hike, picnic, or live in snake-inhabited areas should be aware of the potential dangers posed by venomous snakes. While each individual may experience symptoms differently, the following are the most common symptoms of poisonous snake bites: bloody wound discharge, fang marks in the skin and swelling at the site of the bite, severe localized pain, diarrhea, burning, convulsions, fainting, dizziness, weakness, blurred vision, excessive sweating, fever, increased thirst, loss of muscle coordination, nausea and vomiting, numbness and tingling, and a rapid pulse.

According to the UMMC, call for emergency assistance immediately if someone has been bitten by a snake. Responding quickly in this type of emergency is crucial. While waiting for emergency assistance:
--Wash the bite with soap and water.
--Immobilize the bitten area and keep it lower than the heart.
--Cover the area with a clean, cool compress or a moist dressing to minimize swelling and discomfort.
--Monitor vital signs.

If a victim is unable to reach medical care within 30 minutes, the American Red Cross recommends:
--Apply a bandage, wrapped two to four inches above the bite, to help slow the venom. This should not cut off the flow of blood from a vein or artery - the band should be loose enough to slip a finger under it.
--A suction device can be placed over the bite to help draw venom out of the wound without making cuts. These devices are often included in commercial snake bite kits.
--Most often, physicians use antivenin -- an antidote to snake venom -- to treat serious snake bites. Antivenin is derived from antibodies created in a horse's blood serum when the animal is injected with snake venom. Because antivenin is obtained from horses, snake bite victims sensitive to horse products must be carefully managed.

First aid is critical to administer as soon as possible when a snake bite occurs, according to the Medline Plus Encyclopedia by the National Institutes of Health (NIH):
1. Keep the person calm, reassuring them that bites can be effectively treated in an emergency room. Restrict movement, and keep the affected area below heart level to reduce the flow of venom.
2. If you have a pump suction device (such as that made by Sawyer), follow the manufacturer's directions.
3. Remove any rings or constricting items because the affected area may swell. Create a loose splint to help restrict movement of the area.
4. If the area of the bite begins to swell and change color, the snake was probably poisonous.
5. Monitor the person's vital signs -- temperature, pulse, rate of breathing, and blood pressure -- if possible. If there are signs of shock (such as paleness), lay the person flat, raise the feet about a foot, and cover the person with a blanket.
6. Get medical help right away.
7. Bring in the dead snake only if this can be done safely. Do not waste time hunting for the snake, and do not risk another bite if it is not easy to kill the snake. Be careful of the head when transporting it -- a snake can actually bite for up to an hour after it's dead (from a reflex).

According to the NIH, here are some tips about what NOT to do for snake bite victims:
--Do NOT allow the person to become over-exerted. If necessary, carry the person to safety.
--Do NOT apply a tourniquet.
--Do NOT apply cold compresses to a snake bite.
--Do NOT cut into a snake bite with a knife or razor.
--Do NOT try to suck out the venom by mouth.
--Do NOT give the person stimulants or pain medications unless a doctor tells you to do so.
--Do NOT give the person anything by mouth.
--Do NOT raise the site of the bite above the level of the person's heart.

According to SurviveOutdoors.com, venoms of the pit viper, like a rattlesnake, contain peptides and proteins. The venom leads to damage of vascular cells and red blood cells. Proteolytic enzymes damage muscle and are responsible for tissue death. There is also a histamine release by the body after the bite. There are many symptoms associated with the bite of a pit viper. Fang marks are always present, followed by swelling, pain, and black and blue marks on the skin. Sweating, chills and muscle twitching are commonly seen. Some feel numbness on the tongue, and reports of a metallic taste are not uncommon. Coral snake venom is different than pit viper venom. it is thought that adult coral snakes carry enough venom to kill 4-5 adults. The coral snake venom is primarily a neurotoxin. Fang marks are rarely seen. Swelling is rare. Symptoms may not occur until 10-14 hours later. Symptoms may begin as nausea, vomiting and sweating. Neurological symptoms may include lethargy, difficulty speaking, hard to swallow, drooping eyelids, and in severe cases, respiratory depression or arrest. Dry bites are referred to as “misses,” no venom injected due to the lack of venom, a glancing blow, or penetration could not occur because of the clothing worn by the individual. Dry bites account for about 20-30% of all snakebites.

The UMMC recommends tips to avoid snake bites. Some bites, such as those inflicted when you accidentally step on a snake in the woods, are nearly impossible to prevent. However, there are precautions that can reduce your chances of being bitten by a snake. These include:
--Leave snakes alone. Many people are bitten because they try to kill a snake or get too close to it.
--Stay out of tall grass unless you wear thick leather boots and remain on hiking paths as much as possible.
--Keep hands and feet out of areas you cannot see. Do not pick up rocks or firewood unless you are out of a snake's striking distance.
--Be cautious and alert when climbing rocks.

Make sure that you are familiar with how to respond to snake bite emergencies, especially if you spend alot of time hiking, camping, or doing any other outdoor activities. Knowing what to do in a moment of instant fear can make the difference in life or death when you experience a bite from a venomous snake. Keep first aid supplies handy, and keep your cell phone charged to call for help. Snake bites can be life threatening in cases where individuals are highly allergic to snake bites or when the snake is a deadly reptile.

Until next time. Let me know what you think.