Snakes alive!

So, picture this: you're out exploring in the great outdoors, enjoying nature's beauty, when suddenly you feel a sharp, piercing pain on your leg. Yup, you've been bitten by a snake. Scary, right? Well, fear not, because in this article, we're going to dive into the world of pre-hospitalization care for snake bites. We'll talk why it's crucial to get to the closest medical facility as soon as possible, the steps you can take to administer first aid in the meantime and how this quick action can potentially be life and limb saving. Ok, so let's get started to make sure you're well equipped to handle any slithery encounters.

In the United States there are an average of 8,000 to 10,000 snake bites a year, with about 30 percent (2,400 to 3,000) being venomous resulting in an average of 5.2 deaths a year. These bites mostly occur between April and September and predominantly affect males aged 17 to 27. The snakes most likely encountered in our area are the Crotalines including copperheads, water moccasins (cottonmouth) and rattlesnakes. These snakes use a heat sensitive pit, located between their eyes and nostril to locate prey and predators, hence they are called pit vipers. Pit vipers account for 75 to 80 percent of bites that result in envenomation (the aftereffect of the snake bite).

All of this leads to the question what do you do if you get bitten? Well, the first, and most important thing, is to avoid another bite either to the same patient or to another. Move away from the snake. Do your best to stay calm and remember that fatalities are rare and serious sequela are usually preventable. (risk of death from a snake bite is about 1:400 vs about 1:100 for a car accident-wear your seatbelts folks!)

What to do if you are bitten:

Call 911 -do not attempt to drive yourself.

Lay or sit down with the bite in a neutral position of comfort about heart level.

Remove, rings, watches or tight-fitting clothes before swelling starts

If these can be done without delay in care:

Wash the bite with soap and water.

Cover the bite with a clean, dry dressing.

Mark the leading edge of tenderness and swelling on the skin and write the time alongside it.

But the single most important thing is all snakebites should be transported to the nearest emergency department. Rapid transport to the closest facility allows for life- or limb-saving interventions. We are extremely fortunate to have local facilities capable of evaluating and administering treatment. Both Atmore Community Hospital and D.W. McMillan Memorial Hospital have CroFab (Thank you Escambia County Healthcare Authority). Therefore, in Escambia County most patients are within 30 minutes of treatment.

Now that we have reviewed what to do, let's talk about the things we should not do. Many myths exist when it comes to snake bite treatment that have proven to be either not helpful or harmful (sorry Granny Mable).

Do not:

Attempt to capture the snake (we treat based on symptoms and labs. Treatment is all the same unless it is a coral snake. And please do not bring a snake to the emergency room).

Apply a tourniquet

Attempt to suction the venom

Cut the wound

Use Ice

Use electrotherapy

Take home points: Get away from the snake, stay calm, call 911, get to the nearest hospital. There is nothing that can be done in the field to significantly alter the outcome of a serious snakebite, and field first aid should not delay rapid transfer to a facility capable of safely administering antivenom. The degree of envenomation cannot be quickly determined with confidence; and less than 10 percent of crotalid bites are 'dry bites' therefore, any bite by a venomous species must be considered a medical emergency and evaluated by a physician without delay.

Thanks to the internet, everyone has access to the leading experts in snakebites in real time. The Facebook group "National Snakebite Support" is a 501(c)(3) which is a "non-profit connecting snakebite victims and pet owners with experts who practice the proper management of snake envenoming's". This is a unique opportunity where you have access to leading experts in a field in real time. In the event of a bite they will help with treatment guidelines for you or your pet in real-time and even speak to the treating physician to provide expert guidance. I encourage everyone to join this group.