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Venomous Snake Bites:  Here’s What To Do | Knowledge is Power

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What would you do if you or someone else was bitten by a poisonous snake?  Read on to learn first aid tips that could save a life.

Specializes in Clinical Leadership, Staff Development, Education. Has 28 years experience.

Bitten by a snake?! Be prepared!

Venomous Snake Bites:  Here’s What To Do | Knowledge is Power

Recently, my husband and I decided to enjoy the longer, warmer days of June by spending the day hiking.  I have always called my husband a “snake whisperer”, because he is able to simply “sense” any nearby snake.  Our hike was no exception, as he quickly spotted a rat snake soaking up the sun in a grassy spot.  We knew the rat snake wasn’t poisonous and went on our way without any incident.  However, I was left wondering if I would know how to respond if a snake did bite.

Snake Bites in the U.S.

According to the Centers for Disease Control (CDC), an estimated 7,000 -8,000 people are bitten by a venomous snake every year.  About 5-6 people will die from the bite, however, the following complications are more common.

  • Blood clots
  • Muscle injury
  • Muscle necrosis
  • Nervous system damage
  • Swelling
  • Hypotension
  • Shock
  • Severe allergic reactions
  • Kidney damage

Between 10 and 44% of people bitten by rattlesnakes will experience some form of permanent injury.

Types of Venomous Snakes

In the U.S., there are 4 types of venomous snakes: rattlesnake, cottonmouth or moccasin, copperhead and coral.  Keep in mind, each snake type has many different species.  You can read more about venomous snakes, including where they can be found here.

What Should You Do?

The first (and probably the hardest) thing you need is not panic.  Remember, death by snakebite is a very rare occurrence.   

  • Seek emergency medical attention as soon as possible (dialing 911, calling EMS ect.).  If you experience a serious venomous bite,  the sooner you receive the antivenom-  the sooner any irreversible damage can be stopped.  
  • Take a photograph of the snake from a safe distance if possible.  This will help identify the snake type so first responders can choose the right treatment.

First aid while waiting for EMS includes:

  • Again, stay calm.  This will help slow the snake venom spreading.
  • Sit or lay down and keep the bite below the level of the heart.
  • Remove rings, watches and loosen constrictive closing in anticipation of swelling.
  • Wash the bite with soap and water.
  • Cover the bite with a clean dressing.
  • Mark the edge of tenderness/swelling on the skin with the current time.

Don’t Do This

There are many long-standing myths surrounding venomous snake bites and it’s important to know what NOT to do.

  • Don’t attempt to pick up or trap a snake, even if it's dead.
  • Don’t wait for symptoms to appear if bitten, go ahead and seek medical help.
  • Don’t use a commercial “snakebite kit” that may include a blade for making an incision and a suction device for removing venom.
  • Don’t attempt to cut an incision to “bleed out” or suck out the venom.  These methods are not effective.
  • Don’t apply a tourniquet.
  • Don’t drink alcohol to relieve pain.
  • Don’t try electric shocks.  This approach is outdated and dangerous.
  • Don’t apply ice.

Snakebite Treatment

What happens once you are at the hospital?  The medical team will assess your symptoms and run lab tests if a venomous snakebite is suspected.  Lab tests may include:

  • Complete blood count
  • Basic metabolic profile
  • Prothrombin time
  • Fibrinogen value
  • Creatine kinase value

Your doctor will then determine if an antivenom needs to be administered to stop the snake venom from causing serious problems with your blood, tissues or central nervous system.

About Antivenom

The use of antivenom depends on how  much venom entered your body and the snake’s size.  Size is important because larger snakes usually inject more poison.  Envenomation severity is classified by the following:

Dry bites

This occurs when you are bitten but no venom is injected.  You will have a puncture wound, but no other symptoms.

Mild Envenomations

Symptoms are usually mild, localized around the bite and may include pain, redness and swelling.

Moderate Envenomations

Local symptoms extend several centimeters from the bite to a major joint, such as wrist, elbow or ankle.  These bites are more likely to cause severe pain, swelling of the affected limb, nausea, vomiting, and a general unwell feeling.

Severe Envenomations

Symptoms are severe and include severe pain, swelling, breathing difficulties, moderate to severe bleeding and signs of shock.

Note:  Antivenom should be given as soon as possible, usually within a 4 hour  window.  However, it may be effective for up to 2 weeks (sometimes longer) after being bitten.

Prevention is Best Advice

Here are a few tips on how to prevent snake bites from UC Davis Health.

  • Wear boots and long pants when you go hiking.  These will provide extra protection from venom if you do encounter a snake.  NEVER wear sandals or go barefoot.
  • Stay on trails when hiking.  Snakes are often hidden in tall weeds or brush and cleared trails lead to fewer bites.
  • Don’t attempt to touch or disturb a snake, even if it appears dead.  Remember, newly killed snakes may still be able to bite.
  • Before picking up rocks, sticks or firewood, always look for hidden snakes.  You can easily disturb a snake by lifting a log or rock.
  • Don’t hike alone in remote areas.  It’s best to have someone with you who can assist in an emergency.

Let's Hear From You 

What first aid tips do you have to share from your own nursing (or personal) experience?


References/Resources

How to Prevent or Respond to a Snake Bite

VENOMOUS SNAKES

Snakebites: First aid

J.Adderton, RN MSN has over 25 years nursing experience. Her experience ranges from bedside nursing, nursing education, staff development and project management.

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19 Comment(s)

Julie

Specializes in Sm Bus Mgmt, Operations, Planning, HR, Coaching. Has 39 years experience.

Awesome!  Shared this to all my friends that love the outdoors, hiking, biking and camping.

Kitiger, RN

Specializes in Private Duty Pediatrics. Has 42 years experience.

Thank you. 🙂

Nurse Beth, MSN

Specializes in Med Surg, Tele, ICU, Ortho. Has 30 years experience.

So helpful! I was talking to our rattlesnale anti-venom vendor who told me that adult rattlesnakes prefer not to bite humans, as they reserve their venom to paralyze prey.

Baby rattlesnakes are less regulated and more dangerous. He also said that in his experience patients who have bites on their hands or face and claim they did not try and handle the snake are not being truthful.

It was interesting to me and made them a bit less scary. 

Pixie.RN, MSN, RN

Specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN. Has 13 years experience.

Poisonous: unloads toxins when consumed. Venomous: bites or stings to inject toxins.

I know, I know - picky picky! But someone was going to say it if I didn't, LOL.

Great article! One of my first patients when I was a new RN had a copperhead bite, we were all standing around trying to gently reconstitute several vials of CroFab. LOL. You can't shake the vials or it breaks up the fab fragments. Good times!!

J.Adderton, BSN, MSN

Specializes in Clinical Leadership, Staff Development, Education. Has 28 years experience.

16 hours ago, Pixie.RN said:

Poisonous: unloads toxins when consumed. Venomous: bites or stings to inject toxins.

I know, I know - picky picky! But someone was going to say it if I didn't, LOL.

 

Hey I love it!  Knowledge is power and I learned something new!

handydandy, EMT-B

Specializes in EMT/Urgent Care. Has 6 years experience.

We were taught in school to circle the bite and write the time the bite occurred. True about baby rattlers, they are more dangerous as they don't let go after striking. They're fangs stay latched on, injecting more venom. Thank you for sharing! 

PollywogNP, ADN, BSN, MSN, LPN, NP

Specializes in Med-Surg/Tele/ER/Urgent Care. Has 44 years experience.

Local hospital has sign in parking lot warning visitors not to pick up snakes! Rattlesnakes are common.

Edited by PollywogNP

angeloublue22, BSN, RN

Specializes in Addictions, psych, and corrections. Has 11 years experience.

Perfect timing! I almost stepped on a baby rattler 2 wks ago. It was hiding under a sage brush bush.  My foot landed about 6 inches from it. All I can say is thank goodness they have a warning system! 

There are more than 4 types of venomous snakes in the US. Because apparently you can buy cobras very easily off the internet. And then because people are irresponsible, they get loose. Cuz that just happened in NC this week. (sigh)

RNperdiem, RN

Has 14 years experience.

I live I NC too. Apparently the guy whose snake went missing last week was bitten by another one of his venomous snakes a while back. I hear anti venom is really expensive. Does insurance cover that?

HarleyvQuinn, BSN, RN

Specializes in Military, ER/Trauma, Psych, Post-Partum, Med-Surg. Has 12 years experience.

On 7/2/2021 at 1:01 PM, RNperdiem said:

I live I NC too. Apparently the guy whose snake went missing last week was bitten by another one of his venomous snakes a while back. I hear anti venom is really expensive. Does insurance cover that?

Not sure about insurance, but antivenin is extremely expensive. You also need to be aware of your region and what snakes normally live there, as they aren't going to stock for every type of snake out there. Antivenin has a short shelf life, making it even more expensive. The area I live in ran into a problem because the hospitals didn't stock a lot of rattlesnake antivenin because it's not a "common" bite in the area. The problem is, when someone is bitten, a LOT of it is generally required. Especially if it is a severe envenomation. The ER the patient was treated at ran out, as did the other "sister" facilities that they could source it from. The hospital didn't want to pay to source more from outside hospital networks due to price, but the patient required additional doses faster than they could get from their other affiliated hospitals. This situation, which has been on Untold Stories of the ER, caused a change in policies in how the drug can be sourced, stocking, and policies to prevent the situation from happening again. 

 You also have to remember that a potentially severe adverse reaction to antivenin is anaphylaxis. The risk for this increases with additional necessary treatments (see Venom ER). This is why it's not always used depending on the severity of the envenomation, the patient characteristics, and the stability. The very young and very old are more susceptible to severe symptoms. Most copperhead bites that are seen in this area, as they are the most predominant venomous snake, do not actually require antivenin treatment. Juvenile copperheads, however, like other juvenile snakes are prone to severe bites because they aren't mature enough to regulate the amount of venom they inject. 

 We also have antivenin for black widow spiders. It's also not always needed, depending on the severity of the envenomation and patient stability. 

 What was noted about mixing antivenin is very important. It takes a while to mix up and you have to be gentle with it. You have to monitor the patient carefully, including watching the bite site for progression of symptoms. In the field, keeping people calm and from doing stupid things they've seen on TV or heard (such as the myths noted above) is vital. You want to avoid additional tissue damage being caused or the venom spreading faster because someone panics. Most importantly, do not poke and prod random snakes. They don't like it. Any snake can bite. Even if it's not venomous, it can still cause an infection. I say this, but we had guys playing with the vipers they found in Iraq and Afghanistan. People are strange. 

RN-90

Specializes in Womens health. Has 31 years experience.

Good directions.  Took me back to my first year as a nurse caring for a young man bitten by a rattle snake.  He and his buddies were camping (and drinking) when they heard a "rattlin' sound" so he stuck his hand in a wood pile to see what it was.  Bitten on wrist--entire arm swollen to shoulder by the time they got to hospital.

Brownelfin, ADN

Has 3 years experience.

Just wanted to add, for outdoor lovers, that snakes are much more active and likely to bite in hot temperatures.  On a very hot day in August - temp in the nineties - my dog was bitten by a juvenile copperhead during a hike.  It was coiled under a large kudzu leaf.  The emergency vet stated that he had seen 5 other snake bites that week, and that they always increase in hot weather.

Hoozdo, ADN

Specializes in ICU, Research, Corrections. Has 15 years experience.

9 hours ago, Brownelfin said:

Just wanted to add, for outdoor lovers, that snakes are much more active and likely to bite in hot temperatures.  On a very hot day in August - temp in the nineties

Rattlesnakes do not like temps much over 95. They can't stand anything hotter and hang out in their holes. All bets are off if it rains though, they love the rain. 

I volunteer at a national monument in rattlesnake country in my spare time. I sometimes get involved in a on-going rattlesnake research study when a rattlesnake is caught at one of the 3 nearby national monuments. They are microchipped and released in a safe spot. Fascinating creatures.

 

BetterTomorrowThanToday

Specializes in Flight/ICU-CCU/ER/Paramedic. Has 18 years experience.

A LOT of GREAT ADVICE on this thread. 

Want to add — 

PLEASE (for the love of 8#6oz baby Jesus) DO NOT capture the snake and bring with you to ED or give (in a coffee can 🤦🏼‍♀️) to a flight crew.  We trust descriptions. Well, descriptions and clinical presentations. 
 

This, while it can be confirmatory to a point, it puts me ‘eye to eye’ with potential reptilian badness. And since I am not armed with my snake-killing shovel or .38 (well, as a rule — don’t want to give anything away here 😜) it could go 15 ways on the way to really wrong.  
 

Seriously all, most everyone I’ve cared for in over 25 years with marked envenomation was altered (err... drink or maybe drinking in that direction). Same thing with Lion attacks, but I digress.  
 

Seriously kids, that snake DOES NOT love you. Please don’t try to kiss it. The relationship will end badly, as all relationships with SNAKES of any origin do. 

SmilingBluEyes

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 24 years experience.

Very informative; thank you so much!

12 hours ago, RN-90 said:

Good directions.  Took me back to my first year as a nurse caring for a young man bitten by a rattle snake.  He and his buddies were camping (and drinking) when they heard a "rattlin' sound" so he stuck his hand in a wood pile to see what it was.  Bitten on wrist--entire arm swollen to shoulder by the time they got to hospital.

I am glad there is a cure for snake bite but you can't cure stupid, sadly.