Snake Bites are a ‘Global Health Priority’!
In May 2018 the World Health Organisation passed a new resolution that made snake bites a global priority. This international body says it is in response to the number of medical complications that arise in the aftermath of attacks. It is estimated that there are over 5 million snake bites a year with over 400,000 of these resulting in a disability of some kind.
Globally there are around 100,000 deaths from snake bites every year. The overwhelming majority of these deaths occur in less developed countries that do not have access to the proper knowledge, training and antivenoms. Luckily in western parts of the world we have access to more advanced medical centres and infrastructure.
Dos and don’ts of Snake Bites
As well as knowing what you need to do in the case of a snake bite there are some common myths that also needed to be known and avoided. We go into more detail later in the article but the bottom line is never use a tourniquet.
If you do you can kiss goodbye to whatever part of you is past the tourniquet. The next ten points can be thought of as your basic snake bite first aid. Read on past this list for a complete guide to further symptoms and management.
What to do if you have been bitten by a snake
- Call 911.
- Don’t panic, you want to remain as calm as possible. This will slow the spread of the venom around your body.
- Try and remember the color, shape and size of the snake. Never, ever chase after the snake or try to catch it just to get this information.
- Remove jewelry, rings or watches from any limb that’s been bitten.
- Loosen any tight clothes around the affected area.
What NOT to do if you have been bitten by a snake
- Don’t suck the venom out! If you make it to a medical centre they will want to test the venom so they know what medicine to give you. If you have sucked the surface venom out of your skin the medical team won’t be able to test it.
- Similar to the first point, don’t wash the wound, apply ice or rub insect bite medication into the wound.
- Don’t run after the snake to try and kill it in anger. Likelihood is it will just bite you again.
- Do not raise any bitten limbs like you would if they were bleeding. This will cause the venom to flow back towards your body and heart.
- Don’t wrap anything tight like a tourniquet around the wound. This won’t stop the spread of the venom it will just increase the likelihood that the affected area will need to be amputated once you get to hospital.
A ‘dry’ bite means that the snake’s fangs have not pierced your skin. It may have scratched the surface but having not broken your skin you will not have been exposed to any venom. Remember that because you have just had a potentially very dangerous encounter you heart rate is probably going to be very high!
Don’t take this alone as a sign that you have been injected with venom. If you have a mild scratch with no swelling and a high heart rate you do not need to attend a hospital. Our next section looks at all the varied symptoms you may develop if venom has managed to get into your bloodstream.
Symptoms of a Venomous Bite
You should always initially treat a bite as though it is a venomous one. Being confronted by a snake can be a frightening experience, especially if you haven’t seen many before.
The first step after a strike from a snake is to check the area you felt it bite you. Look for puncture marks made by the snake’s fangs. Even if you find the puncture marks quickly there may already be some redness and swelling around the affected area.
As time progresses various symptoms can start to set in. This alone will encourage you to seek medical attention as quickly as possible. Some symptoms are worrying but not life threatening. Others mean your condition is deteriorating to the point of needed hospital admission.
Of course, the worst case scenario is anaphylactic shock. This is a completely different type of reaction and requires the most immediate attention.
Symptoms from venom will vary from snake to snake and person to person. Although the following symptoms are generally ranked from least to most serious they can appear in any order.
- Increased production of saliva
- Increased sweating
- Numbness of the arms or legs
- Muscle weakness
- Altered vision
- Difficulty breathing
Snake Bite First Aid
The great thing about first aid is that the same basic principles apply in all areas. Whether an earthquake has occurred or someone has been bitten by a snake, the first step of first aid is always to check the environment rather than the patient. This is true even if you are on your own and are the patient!
This guide assumes that you have followed the 10 dos and don’ts listed at the top of the page before carrying on.
Basic First Aid
This obviously includes the snake that has just bitten you. Snakes usually bite a larger animal when they are protecting themselves from what they think is an aggressor. If you stand still because of shock then you are likely still presenting a threat to the snake.
Move away from the snake if you know where it is. If you haven’t managed to see where the strike came from move to a clear area as quickly as possible. A clear area means you can see if you are in danger of being bitten again. From this safe place you can carry on with the urgent next steps.
Make sure you and the victim are out of reach of the snake. Whilst remaining calm contact the emergency services. Recall, if possible, the visual details of the snake.
While waiting for the ambulance to arrive make sure not to clean the wound and that nothing tight is wrapped around it. The victim should not exert themselves physically any more than absolutely necessary. Any spike in heart rate simply pushes the venom around the body faster.
Rule out shock and anaphylaxis
Anaphylaxis is a sudden and severe allergic reaction that some people develop after a snake bite. It can occur minutes or hours after the event so be careful to look out for any signs.
Shock is the least worrying of the two but both require immediate attention to ensure there is no further injury to the bite victim. As they can look remarkably similar but need different interventions below is a comparison of the symptoms.
As a medical condition, going into ‘shock’ means you are having such a reaction that your body is no longer able to properly supply itself with oxygen. It is characterised by progression of the following symptoms:
- Feeling faint and dizzy
- Looking pale and clammy
- A cold sweat
- Rapid breathing
- Sudden blindness
- Nausea and vomiting
- Loss of consciousness
Compare this with anaphylaxis, which can also make your blood pressure drop. Similar symptoms are written below with the differentiators in bold.
- A cold sweat
- Feeling faint and dizzy
- Looking pale and clammy
- Sudden blindness
- Loss of consciousness or collapse
- Itchy, red skin
- Swelling of the face and lips
- Swelling of the tongue and throat
- A wheeze likely associated with the swelling
- Difficulty breathing
- Sustained rapid heart beat
If you are worried that someone has gone into shock or anaphylaxis then the last part of that list is the most important. If none of those symptoms are present then you can be reassured that anaphylaxis has not occured.
The best way to treat someone in shock is to help raise their blood pressure and get much needed blood and oxygen back to their brain. Lie the victim on the ground and raise their legs into the air. This will use gravity to raise their blood pressure and relieve the symptoms of shock.
Remember what we said earlier in the article though. Do not raise the legs if the victim has been bitten on either of them. This may temporarily raise their blood pressure towards normal but it will soon drop again as all the venom drains towards their heart.
The treatment for anaphylaxis unfortunately is a fully equipped medical team. Epinephrine (i.e. adrenaline) is needed urgently to be injected into the affected peron’s body.
This is the only medication that will reverse the effects of the allergic reaction. Emergency services may place some tubing into the patient’s throat at the time to allow them to breathe whilst the medication works.
Any signs of anaphylaxis should always be treated as a medical emergency.
Perform CPR if required
If the snake bite victim is not you, and you see them collapse then you must perform CPR! Do not worry about whether or not CPR will be of benefit or potentially harm them.
At this point, any effort is better than none. If a patient does not need CPR you will realize when they wake up and start to push you off them.
Advanced Snake First Aid
This is really for wilderness survival, extreme situations, and hospital staff. If you are in the wilderness without access to any medical support then these are the sorts of measures you will want to follow.
This is a naturally derived antibody taken from animals. It is produced naturally by the animal’s body whenever it is bitten by a snake. This is completely natural, and the human body does the same thing.
Unfortunately, this does mean for sure that enough antivenom is produced to counteract the snake bite and keep you alive. That is why antivenom is administered through a victim’s veins as soon as possible.
The World Health Organisation have guidelines on who can access antivenom. More importantly, it goes into detail on how these antivenoms are produced and work. It warns against getting antivenom supplies from unlicensed sources. The last thing you want in an emergency is finding out your grey market medicine doesn’t work!
IV Fluid transfusion
This is first aid that is usually delivered by medical professionals and extreme preppers. You first need to know how to gain access to someone’s vein. Just knowing how to use a needle and syringe as you need to with antivenom isn’t enough. Even the largest syringes won’t give you a tenth of the fluid you would need for resuscitation.
The aim of fluid resuscitation is to maintain the victim’s blood pressure whilst waiting for the antivenom. Fluid resuscitation alone is not guaranteed to prevent death in a snake bite victim.
These seem like the perfect anti snake bite tool don’t they? They are pen-like tubes that are designed to be pressed against a bite within minutes of the incident. A button is then pressed which creates a vacuum of pressure that should be held in place for up to 30 minutes.
The idea being that the vacuum would draw up the venom and reduce the symptoms of the bite. Although this all holds up to common sense when this was actually tested, first on pigs and then on humans the exact opposite was actually found.
If you have used a venom extractor in the past you may have been surprised by the amount of fluid that is drawn out of the bite. Sometimes the pen can be filled 5 times before it stops drawing venom, blood and fluid from the wound.
When tested in a lab, however, it was found that this fluid is actually only 0.01% venom! This means that the other 99.99% is still left under the puncture marks and in your bloodstream. Other studies done have shown that the increased pressure may actually push the venom further into your body and instead blood and other fluids are pulled out.
As said in the study which has shown that venom extractors make things worse not better, “the best first aid for a snakebite is a cell phone and a helicopter”
Caffeine and Alcohol – Careful With These!
These two drugs are both likely to put your heart rate up which as already discussed is bad news for a snake bite victim. Being under the influence of alcohol is never a good idea in an emergency situation so just leave it in the immediate aftermath of a bite.
Aside from the potential further injury and stupid mistakes that could be made, excessive alcohol will thin the blood. This could make any snake bite slower to heal.
First Aid Kits to Avoid
The internet can be a scary place. If you want to double check any of the information in this guide a good place to start would government bodies or the World Health Organisation. Any reputable source will tell you that tourniquets and snake bites never go together.
It’s very sad and surprising then to find tourniquets being sold on the internet in first aid kits. Typing ‘snake bite first aid kit’ into google will quickly lead you to a variety of different premade bite kits containing antiseptic wipes and tourniquets. Some of these are very archaic and also contain things like ammonia capsules!
Ammonia capsules are essentially like smelling salts to keep you awake. This may be useful if you are fainting, but they are not a core part of a first aid kit. Raising your blood pressure by lying down as explained here is much safer than kickstarting your heart rate with ammonia.
Top 10 Venomous Snakes
Every year there are 8000 victims of snake bites in the USA. Luckily only around 0.1% of these end up being fatalities. Snakes are fairly common in certain areas, which can make people overconfident in dealing with them. Don’t be one of those people who make up the 0.1%!
In the US there are a wide variety of snakes that you could encounter, especially in the warmer states around the south and the west. On mainland America you can expect to run in rattlesnakes, copperheads and coral snakes to name but a few.
Here;s a top 10 list of the top ten venomous snakes you might encounter:
- Mojave Rattlesnake
- Tiger Rattlesnake
- Copperhead snake
- Black Diamond Rattlesnake
- Timber Rattlesnakes
- Eastern Diamondback
- Western Diamondback
- Coral Snake
- Cottonmouth Snake
- Yellow-bellied Sea Snake
Snake Bite Prevention
This is last in our article so it stays in your mind!
Know your area! This will let you predict your level of risk and the types of snake you could encounter. If you know the pattern already you will be more likely to spot it out in the wild. Snakes are patterned for camouflage, not for recognition so you definitely want to be prepared as possible.
The time of year you venture out also affects your risk. Going out or bugging out during the warmer summer months makes you more likely to come across a snake. During the day, they might be hiding under rocks or fallen trees so be careful where you tread. Once the sun is down the snakes will come out, so make sure to wear long pants and boots when outside.
If you think you have seen a snake, moving away whilst making noise will go a long way in scaring it off. Remember snakes usually bite humans if they feel cornered or attacked. Giving them plenty of room gives them the chance to escape.
There are many varieties and whole books dedicated to this subject. Look at online resources for the main types in your area. For a general overview, look at coral snakes and pit vipers. Coral snakes are very brightly colored, make sure you don’t confuse them with non-venomous king snakes that some people keep as pets!
Avoidance is Key
Despite the deadly venom some snakes carry and their prevalence around the world, deaths in the west from snake bites are comparatively low. This is thanks to a good medical infrastructure and readily available antivenom.
The majority of deaths from snakes bites in the US are due to two reasons. Firstly some may have a severe anaphylactic reaction to the snake bite. This will require immediate medical attention which could spell disaster for those caught miles away from help. Others however will die from their lack of common sense and ignorance of snake bite first aid.
A casual, everything will be fine response is not uncommon. After the initial shock has passed some may feel fine and not seek help. When the venom finally sets in and their respiratory and cardiac systems start to shut down it is too late.
As always, it is best to be fully prepared. If you regularly travel through wooded or grassy areas you should be vigilant for danger. Never aggravate any wild animal, including trying to kill a snake that has just bitten you.
A methodical and safe approach to every snake bite will help make sure that America’s deaths from snake bites continue to decline decade after decade.
The advice given in this article is for information purposes only. Although Shane Jackson is a Medical Doctors with almost a decade of experience in hospitals and surgery, he shall not be held liable for any injuries, side-effects (direct or indirect) as a result of applying the advice given here.
The website www.thesurvivalistblog.net and the company behind it also cannot be held responsible. It’s highly advisable you talk to your doctor about snake bites and snake bite first aid.
Shane is a medical doctor with over 8 years experience in both hospital medicine and surgery. He’s completed over 2 years of surgical work focusing on trauma & orthopaedics alongside maxillofacial surgery. He has been involved in education since medical school and have written courses and taught classes. Having trained in Advanced Trauma and Life Support he is at the forefront of practical, out-of-hospital medicine which can be applied by the public to save lives.