How to Treat Snakebites From Venomous Snakes

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The Eastern Cottonmouth snake.
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The Red Diamond Rattlesnake. As with all rattlesnakes, it is best identified by its rattling tail.
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Learn how to identify the four venomous snakes in the United States. This is the Northern Copperhead.
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The Sidewinder snake.
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The Eastern Coral snake.
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A close-up of a rattlesnake showing erect fangs and heat-sensitive pit.
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The Eastern Diamondback.
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The Timber Rattlesnake.
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This guide may be helpful in identifying venomous snakebites, but it should not be considered a complete guide, because most snakebites leave incomplete markings.

Few creatures are as universally feared as poisonous
serpents, but the fact is that snakebite is a far cry from
the “certain death” that many people consider it to be. To
begin with, the chances of being bitten by any
snake — venomous or not — are slim.

Unfortunately, the only available statistics on the effects
of venomous snakebite are nearly 20 years old and thus
outdated, but if the ratio recorded then still holds true,
only one bite in 3,000 is likely to be fatal, while some
10 to 20 percent produce no effect whatsoever, even if the
snake’s fangs do penetrate the skin! Fatalities occur most
often when elderly people, individuals who are ill or
small children are bitten — or when a person who is
struck receives no treatment. Authorities estimate
that — in the U.S. — there are no more than 12 to
15 deaths from snakebite per year.

Know What Kinds of Snakes are Common in Your Region

The best way to deal with snakebite is, of course, to avoid
getting bitten in the first place. Perhaps the best way
to do that is to know the various serpents and
recognize their preferred habitats.

Of the four venomous snake types in the U.S.,
three — the various water moccasins, copperheads and
rattlesnakes — are pit vipers and share some common
characteristics. All have [a] a pit — or
hole — between the eye and nostril, which is
heat-sensitive and helps the snake locate prey (these
reptiles are also very responsive to vibrations, but can’t
actually “hear”), [b] vertical pupils in their eyes, [c]
wedge-shaped heads that are wider than their necks and [d]
hinged poison fangs that lie flat against the roof of the
mouth when the jaws are closed, then snap forward and erect
when the mouth is opened. In addition, all three have a
venom that’s destructive to blood and tissue and produces
symptoms within a few minutes after being injected.

The most common pit viper in the United States, and the
poisonous snake responsible for the greatest number of
bites, is the rattlesnake. There are
approximately 20 species and subspecies of rattlers: Some
are light, some dark, some marked with diamonds, while
others are blotched or banded. But, all may be
recognized by the horny string of interlocking, loosely
fitted rattles at the end of the tail. When vibrated
rapidly, these rattles produce a distinctive buzzing sound,
but — contrary to legend — the snake may or may
not choose to vibrate its tail when disturbed.
Chief among this group of reptiles are the eastern and
western diamondbacks, which are large and capable of
injecting a sizable amount of poison with one bite.

The copperhead is, by some standards, a rather
handsome snake and the only one in the U.S.
whose hourglass markings are positioned with the
constricted portion of the design down the midline of its
back, as though someone had bent the hourglass across its
spine and down on either side. The color can vary from
almost pink to dark chestnut brown, with only some
specimens having the bright copper-colored head that gives
the species its common name.

The cottonmouth, or water moccasin, is
a heavy-bodied snake with a reputation for bad temper. It’s
difficult to identify quickly because its markings tend to
become indistinct with age. Besides having the usual pit
viper characteristics, the cottonmouth has a broad, dark
band extending from the nostril through the eye to the
angle of the jaw on either side of the head. The interior
of the mouth has a white “cottony” lining that’s visible
when the snake gapes threateningly at an intruder. Unlike
other water snakes, the cottonmouth swims with its head
well above the surface, but it can bite just as easily
under the water as out of it.

The coral snake (which is the fourth poisonous
type in the United States, and the only one that’s not a
pit viper) is easily seen — but just as easily
misidentified. There are, you see, at least three other
serpents with similar markings — the scarlet snake, the
organ pipe shovel-nosed snake and the milk snake — all
of which are harmless. The venomous species is slender and
black-nosed, with bands of red bordered in yellow
and black strips between the red and yellow circlets.
Although the old rhyme doesn’t tell the whole story, “red
and yellow kill a fellow . . . red and black venom lack”
can be a useful adage.

Coral snakes are related to the kraits and cobras of Asia
and have a highly virulent neurotoxic venom that may not
produce symptoms for several hours — by which time it may
be more difficult to treat the victim. Unlike the pit
vipers, these reptiles have poison fangs that are fixed,
rather than hinged, in the jaw. The fangs are smaller than
those of pit vipers, too, and coral snakes must chew in
order to inject their poison. Fortunately, they are
typically passive and relatively uncommon. (“The
chances of being struck by lightning are probably 20 times
greater than those of being struck by a coral snake,”
declares one eminent authority.) Nevertheless, to be on the
safe side, it’s best to give any brightly banded serpent a
wide berth.
Regardless of which of the four venomous snake types may
live in your area, it’s important to keep in mind that
woods and meadows, or even tumbledown buildings, could well
be “home” to poisonous serpents. At one time the reptiles
were typically found in areas of low population density, but that’s no longer always the case. Rapidly expanding
suburbs have usurped some of their old territory, crowding
the creatures into larger groups — sometimes in small,
often recreational, patches of land surrounded by houses.
And snakes whose natural inclination is to live on rock
ledges and in mountainside scree slopes may find similar
refuges in building foundations.

How to Identify a Snakebite

Sometimes the only way to accurately determine whether a
bite is that of a poisonous snake is by examining the
pattern of the tooth marks, so it’s best to learn what to
look for before you need that knowledge. Harmless
serpents usually have four rows of teeth in the upper jaw
and two rows in the lower while venomous types lack
the two outside rows in the upper jaw and have, instead,
two large poison fangs in the front of the mouth. In an actual bite only a portion of
the print is likely to show. If a poisonous snake has
bitten someone, however, one or both fang marks
will almost always be visible, as will perhaps a
few of the smaller teeth.

Incidentally, the bite may be quite bloody even though the
tooth punctures are minute: Snake saliva contains an
anticoagulant, which causes the blood to flow freely for
some minutes after a bite. (This actually cleanses the
wound of bacteria and reduces the likelihood of infection.)
Rinse the blood off with water to see the bite pattern, but
do not use kerosene, alcohol, or any other such
liquids, as they can compound the problems that the
bite itself may cause.

How to Safely Deal With a Snakebite

Another aspect of snakebite prevention lies in taking
precautions when traveling through known serpent habitat.
If at all possible, follow these rules:

[1] Before going out in the field, find out the
name, address, and phone number of a physician competent in
the treatment of snakebite (remember that not all doctors
are equally familiar with these procedures).

[2] Don’t travel alone in snake country. The usual rule is
to stay in groups of no less than three. If one person is
hurt, the second can stay to care for the victim while the
third goes for help.

[3] Wear proper clothing. Don’t select shorts or tight
jeans . . . baggy pants are definitely safer than snug ones
(after all, it’s better to have a striking snake get a
mouthful of britches than a bite of you). And although
hiking shoes do provide some protection, high boots are
better. The latter may be uncomfortably hot in the
summertime, but they’re a must in areas that are
known to be heavily infested.

[4] Always be aware of where you’re putting your hands and
feet. Never reach up and over a ledge
when climbing. If you can’t see the surface, you can’t
be sure it’s unoccupied. Also, don’t sit down on a log or the
ground without checking the area carefully, or step
completely over a log in the path. Instead,
step on top of it first. Not even a snake likes to have a
foot planted on its spine, and it may express
dissatisfaction by sinking its fangs into your leg.

[5] Be sure that you’re familiar with the basic first aid
procedure for snakebite before you need it.

What to do if You are Bitten by a Snake

Of course, regardless of how careful you are, there’s
always a slim chance that you’ll be bitten. Therefore, you
ought to know what to do if the unlikely should happen.

The first thing to do is keep calm. Naturally,
that’s more easily said than done, and it will probably
take all your will power to accomplish it in the face of
the shock and fright a bite will cause, but it’s
vitally important. Increased activity and fear
make the heart beat faster, speeding the venom — if any has
indeed been injected — through your system.

Second, if you can see that the striking snake is one of a
venomous variety, or if you really aren’t sure, kill
it — be certain it’s dead — and take it
with you to the hospital. A physician who knows the size
and species of serpent involved can administer the correct
kind and amount of antivenin.

Third, check the bite pattern. If you find fang marks (or
can’t be sure there aren’t any), apply some kind of
constricting band — such as a shoelace, bandanna,
fish line or whatever you can find — between the bite
and the heart. Place it close to the bitten area if
you’re doing so immediately after being struck. This
will serve to localize the venom as much as possible: The
body can actually detoxify a certain amount of foreign
material if it can be allowed to leak slowly to
the vital areas. The tourniquet should be just tight enough
to allow the insertion of two fingers between the bandage
and the body and it should be left on, without
loosening, for up to an hour or even an hour and a half.

Fourth, if you’ve identified the snake or the bite as
venomous (or, again, if you’re not sure) get to a
doctor as soon as possible. In general, bad bites
will produce symptoms within minutes. These signs include
swelling, purpling, and a painful burning sensation . . .
but remember that coral snake bites, which may not show
clear symptoms for several hours, must also be treated
quickly.

When to Seek Treatment For a Snakebite

There’s considerable controversy over the treatment of
venomous snakebites, much of which is caused by the fact
that a great number of variables can affect the bite’s
severity. Among these are the age and body size of the
victim, the species and size of the snake, the time of
year, the section of the snake’s geographical range where
the strike occurred, the number of bites, their location,
the depth of fang penetration, the length of time the snake
held on, the amount of venom injected, the sensitivity of
the victim to the venom, the kinds of bacteria in the
snake’s mouth, the condition and disposition of the snake
at the time, and the effectiveness and type of first aid
treatment.

At least one widely respected authority believes that any
venomous snakebite must be treated within 30 minutes for
the victim to be relatively sure of recovery. Another feels
that a person can usually stand a delay — if
necessary — of two to four hours before risking serious
consequences. All agree that the victim should be taken to
a doctor or a hospital as rapidly as possible so
that antivenin can be administered.

What is Antivenin?

There are two kinds of snake antivenin commonly
available — to doctors or through prescription
only — in the United States. Both are manufactured by
the Wyeth Laboratory in Philadelphia, both are very
expensive, and both can be dangerous in the hands of a
nonprofessional. “Antivenin (Crotalidae) Polyvalent” is
effective in the treatment of all kinds of pit viper bites,
including those of the fer-de-lance and formidable
bushmaster of South America. “Antivenin (Micrurus
fulvius
)” is used for the bites of the eastern and
Texas coral snakes. If authorities disagree on some aspects
of snakebite treatment, they are all in accord when it
comes to the matter of antivenin: It is not for use by a
layperson.

Antivenin is a chemical counterbalance to the powerful
toxins in snake poison. It is prepared from the blood of a
horse as a dehydrated serum product, and there’s the
possibility that a given individual may be allergic to
horse serum . . . perhaps as a result of previous tetanus
inoculations, which are also prepared from that material.
Such a man or woman could experience a fatal reaction upon
being treated. In very severe cases of snakebite a
physician may elect to use the serum in spite of a victim’s
positive reaction to a sensitivity test, but would then be
prepared to treat the allergy symptoms as they developed using all of the medical equipment at his or her
disposal.

The amount of antivenin needed will vary from case to case.
It’s packaged in 10-cc. vials, and anywhere from five to 30
vials (in rare cases even more) are used to treat the bite
of a diamondback rattlesnake, while a coral snake bite
requires at least three. Administration of the serum is a
complicated procedure involving several steps and a
great deal of care.

Medical attention is also needed for the aftereffects of a
bite. These may include considerable tissue destruction,
and a doctor will have to remove this dead flesh within a
week or so. In the meantime a broad-spectrum antibiotic is
usually given to prevent serious infection. Active exercise
of the bitten part, as it begins to heal, can help prevent
deformation.

Obviously, in view of both the dangers and expense involved
in treatment, it’s
clear that snakebite prevention is of the greatest
importance!

What Not to Do if Bitten By a Snake

Finally, you should know specifically what to
avoid doing if you’re bitten. Here are a few of
the most important do nots: First, do not make an incision and attempt suction of the
wound. This once-recommended treatment often results in cut
nerves, tendons and blood vessels with attendant infection and does little good in removing the poison.

Second, do not put the bitten limb in ice or use
any form of cooling. This procedure, which was
formerly thought to retard the spread of venom, has been
responsible for the permanent deformation or amputation of
many arms and legs.

Third, do not eat or drink prior to treatment, since doing
so tends to speed up the body’s circulation.

Fourth, and perhaps most important of all, do not assume
the worst! The curator of reptiles in one of our finest
zoos believes that possibly 50 percent of all venomous snakebites
actually have no toxic effect. He speaks from experience:
Bitten three times by various pit vipers, he has had a
reaction only once (and that, incidentally, resulted from
the bite of a cottonmouth that was “safely” impounded in a
heavy canvas catch bag).

“If it’s a serious strike, you’ll
know within a few minutes,” he says.

Adds a
pharmacist, “Remember that there’s scarcely a place in the
country where you can’t get to a doctor in plenty of time.”

So, follow the first aid procedures recommended here
and keep calm.

The quotation “the only thing we have to fear is fear
itself” may well be relevant to our dealing with snakes.
Poisonous serpents are fellow passengers on this old planet
and should be treated with respect and understanding. By
using our intelligence and employing a reasonable amount of
caution, there’s no reason we shouldn’t be able to enjoy
encounters with our remarkable neighbors — bringing
back, perhaps, memorable photographs — without getting
hurt.