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?
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.
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.
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.
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.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
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.
I am glad there is a cure for snake bite but you can't cure stupid, sadly.
You can't cure it, but you can generally sedate and intubate it ?
Along with snakes, please don't bring spiders or any other creepy crawlies with you into the ER/Urgent Care/Office. Pictures are fine. Descriptions are fine. No need for all of us to have an emergency at once. ?
RN-90
6 Posts
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.