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Treating and Preventing Venomous Snake Bites
Snakes fascinate many people.
Some are dangerous and others are not.
Gold Miners should be aware of potential dangers posed by venomous snakes. Every state but Maine, Alaska and Hawaii is home to at least one of 20 domestic poisonous snake species. A bite from one of these should always be considered a medical emergency.
About 8,000 people a year get bit by snakes in the United States; 9 to 15 victims die. Even a bite from a so called "harmless" snake can cause an infection or allergic reaction in some people.
Medical professionals sometimes disagree about the best way to manage poisonous snakebites. Some physicians hold off on immediate treatment, opting for observation of the patient to gauge a bite's seriousness. But most often, doctors turn to the antidote to snake venom, antivenin, as a reliable treatment for serious snakebites.
Antivenin is derived from antibodies created in a horse's blood serum when the animal is injected with snake venom. In humans, antivenin is administered either through the veins or injected into muscle and works by neutralizing snake venom that has entered the body. Because antivenin is obtained from horses, snakebite victims sensitive to horse products must be carefully managed. The danger is that they could develop an adverse reaction or even a potentially fatal allergic condition called anaphylactic shock.
Types of Poisonous Snakes
Two families of venomous snakes are native to the United States. The vast majority are pit vipers, which include rattlesnakes, copperheads and cottonmouths (water moccasins). Pit vipers get their common name from a small "pit" between the eye and nostril that allows the snake to sense prey at night. They deliver venom through two fangs the snake can retract at rest but can spring into biting position rapidly. About 99 percent of the venomous bites in this country are from pit vipers. Some Mojave rattlesnakes or Canebrake rattlesnakes, for example carry a neurotoxic venom that can affect the brain or spinal cord. Copperheads, on the other hand, have a milder and less dangerous venom that sometimes may not require antivenin treatment.
The other family of domestic poisonous snakes is coral snakes found chiefly in the Southern states. Related to the much more dangerous Asian cobras, coral snakes have small mouths and short teeth, which give them a less efficient venom delivery than pit vipers. People bitten by coral snakes lack the characteristic fang marks of pit vipers, sometimes making the bite hard to detect.
Though coral snakebites are rare in the United States only about 25 a year by some estimates. There were no deaths, but several victims experienced respiratory paralysis.
Some nonpoisonous snakes, such as the scarlet king snake, mimic the bright red, yellow and black coloration of the coral snake. This potential for confusion underscores the importance of seeking care for any snakebite.
The bites of both pit vipers and coral snakes can be effectively treated with antivenin. But other factors, such as time elapsed since being bitten and care taken before arriving at the hospital, also are critical.
First Aid for Snakebites
"In the past five or 10 years, there's been a backing off in first aid from really invasive things like making incisions," says Arizona physician David Hardy, M.D., who studies snakebite epidemiology. "This is because we now know these things can do harm and we don't know if they really change the outcome."
Many health care professionals embrace just a few basic first aid techniques. These steps should be taken:
- Wash the bite with soap and water.
- Immobilize the bitten area and keep it lower than the heart.
- Get medical help.
"The main thing is to get to a hospital and don't delay," says Hardy. "Most bites don't occur in real isolated situations, so it is feasible to get prompt [medical care]." He describes cases in Arizona where people have caught rattlesnakes for sport and gotten bitten. "They waited until they couldn't stand the pain anymore and finally went to the hospital after the venom had been in there a few hours. But by then, they'd lost an opportunity for [effective treatment]," which increased the odds of long term complications.
Some medical professionals, cautiously recommend two other measures:
- If a victim is unable to reach medical care within 30 minutes, a bandage, wrapped two to four inches above the bite, may help slow venom. The bandage should not cut off blood flow from a vein or artery. A good rule of thumb is to make the band loose enough that a finger can slip under it.
- A suction device may be placed over the bite to help draw venom out of the wound without making cuts. Suction instruments often are included in commercial snakebite kits.
Avoiding Snakebites
Some bites, such as those inflicted when snakes are accidentally stepped on or encountered in wilderness settings, are nearly impossible to prevent. But experts say a few precautions can lower the risk of being bitten:
- Leave snakes alone. Many people are bitten because they try to kill a snake or get a closer look at 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 can't see. Don't pick up rocks or firewood unless you are out of a snake's striking distance. (A snake can strike half its length)
- Be cautious and alert when climbing rocks.
What do you do if you encounter a snake when hiking or picnicking? Just walk around the snake, giving it a little room six feet is plenty. But leave it alone and don't try to catch it."
How NOT to Treat a Snakebite
Though U.S. medical professionals may not agree on every aspect of what to do for snakebite first aid, they are nearly unanimous in their views of what not to do. Among their recommendations:
- No ice or any other type of cooling on the bite. Research has shown this to be potentially harmful.
- No tourniquets. This cuts blood flow completely and may result in loss of the affected limb.
- No electric shock. This method is under study and has yet to be proven effective. It could harm the victim.
- No incisions in the wound. Such measures have not been proven useful and may cause further injury.
Arizona physician David Hardy, M.D., says part of the problem when someone is bitten is the element of surprise. "People often aren't trained in what to do, and they are in a panic situation." He adds that preparation which includes knowing in advance how to get to the nearest hospital could greatly reduce anxiety and lead to more effective care.
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