[pct-l] Snake bites

[Rod Belshee]

Yes, I think the article helps provide perspective that the chances of an 
unprovoked snake bite are extremely low, but indeed they do not tell you 
what to do if you are the 1 in 300,000,000.

For me, I'll go with the statistics:  as long as I do not try to pick one up 
or get close for that photo op while I'm drunk, then the odds of a bite are 
so insignificant that I can focus on the much higher probability risks like 
hypothermia, dehydration, falls, hitchhiking, etc.   Indeed I do not really 
know what to do if I got bit (as you say the instructions are what not to do 
if several days from care).

I guess it gets back to emergency training that the best emergency response 
is prevention of the problem rather than response.  I take some comfort that 
the statistics say as long as I don't do something stupid and provoke the 
snake, then the there are lots of other things I should worry about more 
than snakes.  And, even untreated bites are usually not fatal.  If I really 
ended up with a bite, at least on the PCT the odds of another hiker close by 
who can hightail it out for a rescue is an option. Not a great plan (I'm 
pretty strongly in the camp that you are responsible for self and shouldn't 
depend on others) but again that's the point of looking at real work 
statistics: this just isn't one of the things I need to worry about.

On the other hand, I remember when I spent six months in India and found 
advice that even though ten of the world's most deadly snakes are there, and 
they are in freshwater, seawater, on the ground, and dropping from trees, 
only 10,000 Indians die of snake bites a year against a population of 1 
billion, so the problem is not that bad.  Those statistics didn't reassure 
me at all!  Scaling for population, that risk is 3000 times the problem in 
the US.  So, I'm not dismissive of snakes.  I just consult the statistics to 
figure out what I really should worry about in any situation.

Steady

--------------------------------------------------
From: "Reinhold Metzger" <reinholdmetzger at cox.net>
Sent: Thursday, October 14, 2010 10:57 PM
To: "PCT" <pct-l at backcountry.net>; "Deems" <losthiker at sisqtel.net>; 
"Hiker97" <hiker97 at aol.com>; "MONTE DODGE" <montedodge at msn.com>; "Stephen" 
<reddirt2 at earthlink.net>; "scott williamson" <duckface99 at gmail.com>; 
<Acu4harmony at aol.com>; "joseph kisner" <lostonthecrest at hotmail.com>; "''Adam 
Bradley''" <tooloouk79852 at yahoo.com>; "Brian Robinson" 
<brian.robinson at sbcglobal.net>; "french bob" <cyrille.soulas at gmail.com>; 
"Sorensen, Aaron BM1" <Aaron.W.Sorensen at uscg.mil>; "Michael Popov" 
<michael.popov at yahoo.com>; "Al Shaver" <alshaver2000 at yahoo.com>
Subject: Re: [pct-l] Snake bites

> 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.
>>
>>
>
>
>