[pct-l] Snake bites

[Rod Belshee]

Informative article:
  Large Snake Size Suggests Increased Snakebite Severity in Patients Bitten by Rattlesnakes in Southern California
  WILDERNESS & ENVIRONMENTAL MEDICINE, 21, 120-126 (2010)

   Full article:  http://download.journals.elsevierhealth.com/pdfs/journals/1080-6032/PIIS1080603210000645.pdf  

  Key findings:  most snake bites are provoked (especially by young males and alcohol is often a factor); dry bites without envenomation are rare; death or long-term disability is extremely rare; the popular belief that small snakes inject more venom is a myth; where you get bit is not a big deal (e.g. arm vs. ankle), and the variation between rattlesnake species is not correlated to severity.  Basic conclusions for PCT hikers: don't provoke snakes, give them their space; but if bit anyway do not panic, just get to medical care and you will be okay.
Article Abstract
  Objective.-To correlate rattlesnake size and other characteristics of envenomation with the severity
  of envenomation.

  Methods.-We retrospectively reviewed 145 charts of patients bitten by rattlesnakes in Southern
  California between 1995 and 2004, measuring Snakebite Severity Scores (SSS) and characteristics of
  envenomation that might be correlated with snakebite severity, including rattlesnake size, rattlesnake
  species, patient size, and anatomic location of the bite. Outcomes measured included SSS, complications
  of envenomation, number of vials of antivenom used, and length of hospital stay.

  Results.-Of the patients bitten by rattlesnakes, 81% were men, and 79% of bites were on the upper
  extremities. Fifty-five percent of bites were provoked by the patient, and 44% were unprovoked.
  Neither location of snakebite nor provocation of snakebite affected the SSS. Only 1 patient had a
  snakebite without envenomation, and only 1 patient died from envenomation. Rattlesnake size was
  positively correlated with SSS, and SSS was positively correlated with the number of vials of
  antivenom used and with the length of hospital stay. Rattlesnake species and patient mass did not affect
  SSS.

  Conclusions.-Larger rattlesnakes cause more severe envenomations, which contradicts popular
  belief.