[pct-l] Snake bites

[Reinhold Metzger]

Each year 8,000 people receive poisonous snake bites in the USA.
Many of those bites occur in low risk areas and I would venture to say 
that if all 300,000,000 Americans lived in higher risk areas like the 
California desert or along the PCT the bite count would increase 
substantially
Let's see now if, as the article says, only 44% of the 8,00 bites are 
unprovoked that would mean that there are approximately 3,500 unprovoked 
poisonous snake bites in the USA.
Did you say that should not be a reason for concern because they are 
hardly ever fatal and hardly ever cause severe
permanent damage?
I would like to point out again that the reason for the low fatality and 
permanent damage is because the vast majority of snake bite victims 
receive medical treatment within a few hours.
A hiker, 2-3 days removed from civilization, might not be so lucky.
The risk goes up dramatically if medical treatment to the bite victim is 
delayed.
Let's see now, how many bear or lion attacks occur each year in the USA?
I believe it is somewhat less than the 8,000 poisonous snake bites, yet 
hikers do seem to be concerned about bears and lions.

JMT Reinhold
-------------------------------------

Rod Belshee wrote:
> 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.
>>>
>>>
>>
>>
>>
>