July 21, 2003

Snakebite
by James L. Cummins

Almost everything surrounding a snakebite is controversial. According to Dr. Bill McKell, "I have seen it alluded on more than one occasion that 'a sober person, properly clothed, behaving sensibly, is almost never bitten.' I venture to presume that a percentage of the 45,000 snakebite victims each year in the U.S. would refute this."

Dr. McKell has several suggestions about what we should and should not do for the victim in the field. They are as follows:

1. Make sure the victim is away from the snake and out of danger of additional bites. If it can be accomplished quickly and safely, kill the snake for identification. Remember that completely severed heads can still inflict bites and inject venom.

2. Arrange for transportation to a hospital Emergency Room as soon as possible. Keep the victim calm and still. Do not give him or her alcohol, for it dilates blood vessels and enhances the spread of venom. If possible, have the victim lie flat with the bitten limb at the same level as the heart. Remove rings and other constricting jewelry.

3. "Tourniquets" are out. It is almost universally recommended that one apply a large "constricting band" at a level between the bite site and the heart. Taking care not to constrict arterial blood flow, this band should allow your little finger to slip under it. Don't remove the band until antivenin is administered or decided against.

4. Incision and suction are no longer recommended.

5. Do not use ice or electric shock.

6. Prophylactic antibiotics are frequently given, but are of little benefit. If tetanus immunization isn't current, this should be rectified.

7. Antivenin: The only product approved by the Food and Drug Administration is associated with 10-25% rate of immediate allergic reactions and an almost universal experience of delayed allergic reactions. For this reason, the routine use of antivenin for all pit viper bites is not recommended. Though each case should be individually assessed, rattlesnake bites in children will usually be treated and patients with copperhead bites will generally not be given antivenin therapy. One must remember, however, that up to 30% of pit viper bites are "dry", meaning that no venom was injected and, therefore, no further treatment indicated.

"Snakebite victims, without exception, should be immediately taken for medical evaluation. If the patient is within an hour or so from an Emergency Room, first aid measures such as the constricting band may be omitted," concluded McKell.

James L. Cummins is Executive Director of the Mississippi Fish and Wildlife Foundation in Stoneville, Mississippi. Known as "Wildlife Mississippi," the Foundation is a non-profit, conservation organization founded to conserve, restore and enhance fish, wildlife and plant resources throughout Mississippi