[pct-l] Snake bites

[Reinhold Metzger]

Reinhold Metzger wrote:
Rod,
Very informative and down to the point.
I have been hiking the Grand Canyon for 30+ years and had my share of  
Rattlesnake encounters...even stepped on one at Shinumo Creek in the 
Merlin Abyss in the Grand Canyon a few years ago.
Lucky for me, his front half was in the bush which restricted him from 
whipping around and I was able to jump back before he could strike.
I must say I am more concerned about Rattlesnake encounters than about 
bear encounters.
I can usually take the proper bear precaution to reduce the threat of a 
bear encounter.
There is, however, not a lot I can do to prevent a snake encounter 
unless I am willing to hike ever so slowly and keep my eyes glued to the 
ground.
Turning up the volume on my ears to full blast and listening for the 
rattle won't help me neither since, like Chuck, my hearing is not so good.
Lost 97% of my high frequency (to many bazooka rounds in Vietnam) and 44 
years later I still have this ringing in my ears.
The good thing about this, I don't have to put ear plugs into my ears to 
drown out a gurgling creek or Switchback's snoring.

What bothers me is that all the snake bite First Aid Instructions go 
something like this....stay calm, don't exert yourself, do not apply 
restriction band, do not induce bleeding by cutting fang marks, do not 
use suction pump..."Seek Medical Care"....snake
bites are hardly ever fatal or cause permanent damage.
This is great advice if you are close to civilization.
What about a solo hiker who is 2-3 days removed from medical care.

I t is true that snake bites are hardly ever fatal or cause permanent 
damage  BUT, only because the vast majority of snake bite
victims receive medical care within a few hours.
So, what is the solo hiker bite victim, 2-3 days removed from medical 
care, supposed to do?....Nothing?
The fatality or permanent damage risk factor goes up drastically when 
medical care is delayed.

JMT Reinhold
aka "The Canyon Rat"
--------------------------------------------------------
Rod wrote.....
> 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.
>
>