Question About Snakes

My wife and I are both docs, and have treated snakebites. I have been involved for many years with keeping and breeding snakes (including poisonous) and have lectured on the topic of snakebites.

Here is what I would do if I was bitten:

Lower the wound and immobilize it if possible.

Clean the wound with soap and clean water.

If possible, and safe to do, identify the snake (picture is good, dead snake can be risky, personal knowledge of snakes you are likely to encounter is good)

Pressure bandage above the wound. Do not cut off blood flow! (do not ever use a tourniquet unless you are bitten by a snake that will kill you in a very short period of time; Black Mamba, King Cobra, Inland Taipan, etc.) The chances of dying from a native species snakebite in North America are very, very low for a healthy adult. I personally would never use one for a bite in the USA on myself.

Get to help as quickly and as calmly as you can. Anti-venom is your friend, unless you have a severe anaphylactic reaction to the antivenom (not as common with the newer crotalid antivenom). Remember that dry (no venom injected) bites do occur with considerable frequency.

Do not apply ice, electrocute, cut open, or use your mouth to suck the poison. If using a Sawyer Extractor makes you feel better, go for it (as long as you are not wasting your time with the suction device instead of getting to help). Personally I do not carry one, and I frequently hike in the Everglades. I know several well known herpetologists that do have them nearby, but all of them will tell you they would only use it while being driven directly to a hospital (waste no time getting to help).

Call ahead to the hospital and tell them exactly what happened. This will get them started on finding antivenom right away.



P.S. If you don't believe in pinhead doctors, and white coat types, do not mention this to the doctor when you show up crying that you have been bitten;)
 
My opinion to a snake bite shoot it off:D:D:D

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JMHO
 
Don Rearic said:
There is a webpage where this little boy has his epic saga of a tangle with a rattlesnake, I cannot remember if his hospital bills were half million or three quarters of a million.

Two drops of venom out of the wound can make not only thousands of dollars worth of difference, but the pain and suffering that doesn't have a dollar value...might be lessened.

Possibly more than two drops if you get the Sawyer on it within five minutes? Priceless.
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That's probably true as well. Even best case scenario, you're looking at around $40,000 for uncomplicated treatment with antivenin.



Don Rearic said:
Now, to be perfectly honest about it, using the Sawyer out in the wilderness where you might get bitten and might not be able to be rescued might make you die a more lingering death. You might get the amount out that would have killed you faster. Hell of a thing...survival is.

Again, the scenario being, you cannot receive medical help in anything remotely resembling a "timely" manner. Over the years, there has been "cut and suck," there has been electro-shock with stun guns, icing, this, that and the other. We're not really talking about those things and I am not promoting them. I am simply saying that every drop of venom you can get out of the bite area is a good thing and could mean the difference between life and death and that means that the simple possession of a Sawyer Extractor could possibly mean the difference between life and death - which also does not rule out trying to slow the spread of the venom you cannot extract with ligatures, etc., as has been discussed earlier in this thread.

But to simply say that getting some venom out, any amount, is "bad" or a "waste of time," to me...is simply ridiculous.
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Well, to a certain extent. You also need to take into account whether the treatment entails any adverse or detrimental effects. Take the cut and suck method, for instance. Not only are you already dealing with potential bleeding disorders, but now you have increased the risk of infection by an untold amount. No one needs to tell you how bad a systemic infection could be in the wilderness. The extractor alone seems to be a much better stopgap measure for whatever its worth because it doesn't have any of these detrimental effects.
 
Rack 'em if ya' gottam' I always say!

I worked with Dr Haas for a little more than a year at the Miami Serpentarium back in my Herpetology days....Miss his flyin' hands....talk about martial arts fast!!
 
Don Rearic said:
Upon re-reading that "abstract," I'm sure the Docs really piledrived that needle and instantly injected the full load instantly like a pit viper would. They wouldn't have too many other test subjects had they done it fast and hard, they don't list the duration of the injection but list the wait time until the Sawyer was applied. To me, that's a really big flaw right there. The surrounding tissue would have time to absorb more of the "mock venom" unless they literally rammed the needle in and instantly created the same type of abscess-like pocket with which the Sawyer might have better results on.
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I can tell you that the needle they used was fairly large; large enough to administer blood products through. It was, however, pretty short. 1cm is going to be a subcutaneous injection on most people rather than an intramuscular injection. Subcutaneous injections have a definitively higher rate of absorption than intramuscular injections. An intramuscular injection might have yielded better results or a better abscess from which to draw. Maybe 1 cm is the average depth of penetration for recorded snakebites. I don't know. But that isn't the best way to mess with the test. The best way would have been to use an IM injection with the z-track method. That would all but insure the sawyer would do nothing.
 
Ummm....I was always taught that tourniquets were applied with a wide dressing like like an Esmarch bandage and released every 15 mins for a minute to allow blood flow to prevent necrosis of the tissues. This seems to be the best method to allow the toxin to be released into the body slowly, increasing one's ability to deal with it.

Granted, it's been a while since my training...
 
Wow i leave for the weekend and theres a full fledge bar fighting going on.

I am going to stay out of it for sure, will only say two things


tourniquets-pressure bandage- i have talked to a lot of "lay" people and some emts and a Doc and there seems to some over lap in those two terms. Sort of like calling a truck a car, we know what your talking about, but its not right-kind of. Make sure that you know the difference between the two and or when some one else told you to use one that they did not mean the other. Applying any type of full circumference bandage that is tight should always be done with care weather snake bite or not.

About the Sawer thingy, i dont care if it works or not, i really dont. If i get bit i will use the $15 gizzmo. And you know what i will think that it will help clam me down. It will make me feel better, then i will walk to the ER how ever i can. The reason i will use it even if i dont think it works is that un like cutting ect. it will not harm me in any proven way. So at least its safe either way.
 
And you are a hardhead, as usual, that doesn't read.
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And you're a wanker who believes anecdotal evidence over peer reviewed scientific studies.

There, we're even.
 
Personally I think an ounce of prevention is worth a pound of cure in this case.

Lord knows being bitten by a snake in the wilderness is not anyone's idea of fun, so here's a few ways to prevent this from happening:

Make a fair bit of racket and stomp heavily when walking through dense grass. Snakes will pick up the vibrations and hightail it out of there before you arrive if they know you are coming.

Always wear substantial ankle high (or higher) boots when hiking. Obviously snakes are usually low to the ground, so bites will often be directed at the feet and ankles.

Before you sit down on a hollow log or tree trunk, give it a few whacks with your hiking staff to scare off any slithery inhabitants.

Never carelessly kick over rocks or logs as you can't be sure what's sleeping underneath them.

Make sure your tent is securely zipped up at night, snakes seek areas of warmth and will quite happily slip into your sleeping bag for a snuggle on a chilly night.

By the same token, shake out your sleeping bag before crawling into it at night. Same goes for your boots, though this is more of a scorpion/spider hidey hole.

If you hear a rattling noise, pick up your skirts and run like hell! :D
 
jh205 said:
And you're a wanker who believes anecdotal evidence over peer reviewed scientific studies.

There, we're even.
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Yeah, a flawed study. For reasons I already posted and "CaptInsano" expounded upon, it's a flawed study. If you are going to use a stopwatch and set three min. until you apply the Sawyer, I wonder why they didn't inform the reader how long the injection took?

I wonder...

As far as CaptInsano's further statements, I have no problem. I see now that it was more of a disagreement because I don't worship at the Altar of the Seventh Day Asclepius (had to check the spelling on that one!).

As for the Doc that posted. I don't trust any stranger just because they have one to fifteen degrees on the wall or they are wearing a labcoat or whatever. I don't trust anyone until they prove themselves trustworthy. When I MUST trust them, I do. I'm not stupid. I also don't insult people unless they have it coming.

Oh yeah...I don't know why anyone is bringing up "Cutter" Kits, that was actually a brand name at one time as well, but cut and suck...I think we have more than enough common knowledge that you don't want to expose fresh tissue to the venom.
 
Don Rearic said:
As for the Doc that posted. I don't trust any stranger just because they have one to fifteen degrees on the wall or they are wearing a labcoat or whatever. I don't trust anyone until they prove themselves trustworthy. When I MUST trust them, I do. I'm not stupid.
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I don't trust everyone just because they have a degree either. However I would listen to an expert in a lab with an advanced degree, before I would put my trust in an idiot who saw some fluid that he thought was venom in a Sawyer while riding in the back of a truck.

Sounds like you are a "FoxHole Patient". It is kind of like a foxhole atheist.
You say you don't believe in doctors much, but when you are in trouble you go to one.
 
Don Rearic said:
Yeah, a flawed study. For reasons I already posted and "CaptInsano" expounded upon, it's a flawed study. If you are going to use a stopwatch and set three min. until you apply the Sawyer, I wonder why they didn't inform the reader how long the injection took?
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Do realize that an abstract is not the whole study?

Have you read the actual Alberts study? Any study?
 
Don Rearic said:
Yeah, a flawed study. For reasons I already posted and "CaptInsano" expounded upon, it's a flawed study. If you are going to use a stopwatch and set three min. until you apply the Sawyer, I wonder why they didn't inform the reader how long the injection took?
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A 1mL injection, while not instantaneous, would take a matter of a second or so.
 
Richard in OK said:
Two things to think about:
1. Several years ago an MD on public radio said the best treatment for a snakebite is the key to a car that works.

2. Most (80% of venomous bites happen to people who are a) intoxicated, or b) messing with snakes (or both). I think that was in Field and Stream last year.
Richard
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Okay, tongue is planted firmly in cheek, but wouldn't it perhaps compound the situation in scenario 'a'? I'm only suggesting that well too much to drink, played with a snake....AND got bit. Oh, what the hell here comes the third pitch....hop in boys were a gonna go fer a ride!!! And steeeerrrrrikkkkke three-you're out! I wish that I could relate this story by means of my vivid imagination, but alas and unfortunately I'm ashamed to admit that I'm actually acquainted with a few folk o' this caliber.
 
Do realize that an abstract is not the whole study?

Have you read the actual Alberts study? Any study?
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Who needs a scientific study when you've got your buddy's aunty's sister's mailman who swears that the Sawyer Extractor worked on his cousin's girlfriend?
 
Why do you guys argue from a dishonest position? We have went far afield here, don't you think? I already said that this sort of thing applies to people who are out in the wilderness and cannot receive medical attention for at least hours. Why do you make it sound like you can pull an ER Physician out of your ass with a shot of antivenin/venom? I already told you that I wouldn't have an issue with getting to a hospital because of where I live. But, again, the people who are so smart have to make themselves appear to be smarter by saying, "You have to make it to us smart people."

What if the person CAN'T?

Well, obviously, in many cases, they are going to die. So, in a way, why don't you and the rest of the wunderkind tell the truth, "If you are bitten by a rattlesnake and you cannot reach medical attention within 6 hours and it's not a dry bite, it's quite likely you are going to die."

Seems a lot more honest to me.

But, this from the good Doc is stunning:

You say you don't believe in doctors much, but when you are in trouble you go to one.
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Did it hurt your ego that not everyone blindly trusts people in your profession?

You're a fool, that's not what I was saying at all. Apparently you glossed over that portion.

You have shown the very same arrogant, shitty attitude that makes me despise many people in your profession to begin with. You ask them a question and they simply ignore you, you ask for something to be explained and they act like you're a moron and they don't have time to explain something to one of the Great Unwashed. In short, you're acting like an ass because you took offense at something I said. Pretty cool coming from someone in a profession that is being taken to task because they can't be bothered to wash their lab coat more than once a week. I heard this debate on MRSA on C-SPAN and WHOA BOY, you people in hospitals have some SERIOUS cleanliness issues.

Have a nice read on the lab coat issue...

http://epablog.wordpress.com/2007/07/21/mrsa-report-cites-irresponsibility-everywhere/
 
So there are two types of treatment for snakebite, prior to getting to hospital for treatment with antivenom. The first is to keep the patient calm and apply a firm pressure bandage from the bite along the length of the limb. The second is to use the Sawyer Extractor.

What does each treatment do? The first method limits the amount of toxin being transported throughout the body, whilst the second method extracts a tiny and clinically insignificant amount of venom from the wound, whilst allowing the majority of the toxin to be freely transported.

Anyone with half an ounce of common sense can see what the appropriate treatment is.
 
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