Snake Bites: Here's What to Do [Video]

Posted by: Tod Schimelpfenig on 6/19/15 9:23 AM

When the weather warms up, that means the reptiles are out of their winter dens and ready to enjoy some sunshine—just like you, your friends, dogs, and everyone in between.

Backpacking

Photo by Frank Jiang.

Since we're sharing the great outdoors with these reptiles, it's a good time to know what to watch for to prevent snakebites. As always with wilderness medicine, prevention is the name of the game here. Be mindful of where you are walking, and if you're in known snake habitat, consider keeping your pet close by or on a leash.

Which Snakes Should I Look Out For?

In North America, snake envenomations (where the snake bites and injects venom), are generally caused by Crotalids, the family of snakes that includes pit vipers like rattlesnakes, water moccasins, and copperheads. Less common, but still found in the U.S., are Elapids, the family that includes coral snakes.

Although there are about 8,000 venomous snakebites in the United States each year, there are usually only around 5-6 fatalities (according to the University of Florida Department of Ecology and Conservation). That means you're nine times more likely to die from a lightning strike than a snake bite. In fact, nearly a quarter of bites delivered by pit vipers and half of those delivered by coral snakes don't deliver any venom at all! So, while you certainly need to take care to prevent snake bites, you also don't need to panic every time you hit the trail.

With that in mind, let's look at the different signs and symptoms of various snake bites, how to treat them, and, most importantly, how to prevent snake bites in the first place.

Signs and Symptoms

Pit Viper Bites (Rattlesnakes, Water Moccasins, Copperheads)

  • Fang marks
  • Swelling and pain. If absent after 30 minutes, envenomation probably did not occur.
  • Ecchymosis (skin discoloration resulting from bruising) and bleb formation (a pressure cyst) over 6-36 hours, and later necrosis (death of body tissue)
  • Weakness, sweating and chills
  • Nausea and perhaps vomiting
  • Numbness and swollen lymph nodes
Rattlesnake

Rattlesnake, member of the Crotalid family. Photo courtesy of the National Park Service.

Coral Snake Bites

  • Local swelling, nausea, vomiting
  • Dizziness, weakness, respiratory difficulty (up to 12 hours after bite)

Treatment Principles

All Snake Bites

  • Scene Safety! Try to identify the snake, but not if it puts anyone at risk
  • Keep yourself and the patient calm
  • Avoid walking
  • Remove constricting clothing and jewelry from the bite site
  • Consider pain medications
  • Monitor for signs of envenomation
  • Splint the extremity
  • Avoid elevating the injury

Pit Viper Bites 

  • Measure and monitor swelling

Coral Snake Bites

  • Apply a wide elastic bandage (pressure immobilization bandage) wrapped distal to proximal (from the limb towards the center of the body). Wrap it about as tight as an ankle wrap

DO NOT:

  • Cut and suck the bite
  • Use a suction device
  • Apply ice
  • Use electricity, a tourniquet or constricting band on pit viper bites

Check out our Mythcrushers video on North American snakebites if you still aren't convinced:

Prevention

  • Plan ahead and prepare: Know if you are traveling in snake country
  • Respect Wildlife: Don't pick up or corner a snake
  • Avoid blind placement of hands and feet in suspect areas
  • Avoid traveling at night without a light

Treatment

  • In general, treat Elapid bites with a pressure immobilization bandage, and viper bites with immobilization. Evacuate both to hospitals for anti-venom.
  • Research local snakes prior to travel for prevention advice, local treatment protocols and availability of anti-venom.

Evacuation Guidelines

  • Evacuate all patients bitten by a snake.
  • Rapidly evacuate patients with signs or symptoms of envenomation.

And remember, prevent snake bites in the first place by being aware of your surroundings!

References

  • Johnson, Steve A., PhD. Venomous Snake FAQs. University of Florida Department of Wildlife Ecology & Conservation. 
  • Signs, symptoms, and treatments from the  NOLS © Wilderness Medicine Handbook 2010 NOLS Wilderness Medicine Institute. All rights reserved.

As a NOLS Instructor since 1973 and a WEMT, volunteer EMT on ambulance and search and rescue squads since the 70s, Tod Schimelpfenig has extensive experience with wilderness risk management. He has used this valuable experience to conduct safety reviews as well as serve as the NOLS Risk Management Director for eight years, the NOLS Rocky Mountain Director for six years, and three years on the board of directors of the Wilderness Medical Society, where he received the WMS Warren Bowman Award for lifetime contribution to the field of wilderness medicine. Tod is the founder of the Wilderness Risk Manager’s Committee, has spoken at numerous conferences on pre-hospital and wilderness medicine, including the Australian National Conference on Risk Management in Outdoor Recreation, and has taught wilderness medicine around the world. He has written numerous articles on educational program, risk management and wilderness medicine topics, and currently reviews articles for the Journal of Wilderness and Environmental Medicine. Additionally, he is the author of NOLS Wilderness Medicine and co-author of Risk Management for Outdoor Leaders, as well as multiple articles regarding wilderness medicine. Tod is currently the Curriculum Director of NOLS Wilderness Medicine.