[pct-l] Rattlesnake Bites / MODERN Emergency Room Doc viewpoint

[Don Billings]

Jim,

What you stated appears to be mostly up to date. 

There is an ER medical doc in Southern California whose specialty is snake bites. He produced a paper for the medical community which I read 
and found to be useful to lay people. About 1/3 of it was too technical, but 2/3 of it was pretty darn clear. They also did a TV special
on the guy because his own son was bitten by a snake (probably due to following his father's interest in snakes).

Essentially, the doc stated several things that I'll post here.

He stated that the "cut & suck" method of years back has been found nearly worthless and that there is no real field treatment. The 
treatment for snake bite today is MED-I-VAC to the nearest medical facility. The victim is not supposed to walk if possible, but 
transported by whatever means available. Most bites (roughly half) are "dry bites" where the snake penetrates the victim with its fangs but does not
inject venom... this is a puncture wound that still requires medical treatment. 

In the old days, they used to ask that victims kill the snake and bring it in for ID in order to determine the proper anti-venom medicine. That is no
longer the case. The modern snake anti-venom vaccine has been formulated to work on the most common bite venoms. i.e. combo effectiveness.

THE MOST INTERESTING ASPECT OF HIS INTERVIEW: most people think that the anti-venom stops the damage to the victim. It does not. 
Repeat: anti-venom does not stop the venom damage. It stops fatalities. The damage to the human body often results in loss of use of the 
affected part (fingers, hand, toes, feet) for months. Sometimes, amputation is required. So snake bites are still a very, very serious injury
even though, as you said, they are somewhat rare so long as the hiker keeps his feet and hands out of areas that might hide snakes. i.e. rocks,
wood piles, etc. So, although modern anti-venom medicine has reduced fatalities in the USA to about 1% or less each year, the physical
damage to victims can be major, irreversible, and permanent.

Hope this helps. If you would like a link to the doc's paper, I can try to find it for you. I found it after realizing that I had not idea of how to 
respond to a snake bite emergency for myself or others... and I began to research via google. I had asked some fellow hikers what they
would do in the event of a bite and they had no clue, either, after we had just passed a very beefy, 4 foot rattler. FYI: there is a brand of
snake gators on the market and their website shows a demo with live snakes biting the wearer as he taunts them. Maybe 85% of the strikes,
as you can see in the video, are between the kneed and the ankle. Some were on the top of the foot itself. 

Don





----- Original Message ----
From: Jim Banks <jbanks4 at socal.rr.com>
To: pct-l at backcountry.net
Sent: Tue, March 23, 2010 5:46:26 PM
Subject: [pct-l] Rattlesnake Bites

I was an Emergency Medical Technician while working with the U.S. Forest
Service for 10 years back in the 1970's and early 1980's.  In all that time,
plus over 40 years of backpacking, I have never seen a snake bite.  They are
very rare.  Most cases occur when someone is messing around with the snake.



The latest Wilderness Medicine Institute's backcountry first aid book says:



1.        Get away from the snake.

2.       Try to remain as calm as possible to keep your heart rate down.

3.       Remove anything that might restrict circulation (rings, tight
belts, etc.)

4.       Gently wash the bite sight

5.       Keep the bite site on a level with the person's heart (obviously
this is not going to work if they were bitten on the leg and they have to
walk out)

6.       Get the person to a doctor.  Carry them if you can, but if not help
them walk slowly

7.       Give acetaminophen for pain, but do NOT give any kind of
nonsteroidal anti-inflammatory drugs like ibuprofen and aspirin

8.       Do NOT use cold packs, tourniquets, cutting, or sucking.





I-Beam





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