Snake Bite (HB)

PIC OF SNAKE OR BITE

Snakes have a straightforward outlook on life. If it fits in my mouth, I will try to eat it; if not, I will try to avoid it.

Any time any snake bites us, we run the chance of an infection, just like any puncture type wound.

With venomous snakes is the possibility that they inject us with venom. Snakes use venom to assist them in getting and enjoying a meal. Some venoms contain compounds that affect the nervous system to paralyze the prey (neurotoxic), and some venom is intended to break down the tissue to aid in digestion (hemotoxic). Some venoms can have both hemotoxic and neurotoxic effects.

Snakes can only produce so much at a time and can only store a limited amount of venom.

Rattlesnakes, cottonmouths, and copperheads are classified as Pit vipers. Pit vipers can use their venom as needed, meaning they can bite without using venom–this is called a dry bite. Pit vipers use a hemotoxic venom that, when injected, starts to break down and destroy the tissue it comes in contact with. (The Mojave Green Rattlesnake uses both Hemo and Neurotoxins–but this is merely interesting).

Pit vipers like to strike from a coiled position and will assume this position when threatened. When they strike, they can reach out one third or more of their body length at speeds of 150 MPH. They can open their mouth almost 180 degrees, allowing the top fangs to assume an orientation that is effective for piercing the skin. These fangs act like syringes.

The other type of venomous snake found in the United States is the coral snake. Coral snakes are classified as elapids, and their venom is a neurotoxin. Coral snakes have rows of tiny teeth that are designed to hang on to their prey. The venom is contained in a sac that gets released into their mouth and enters the tissue as they gnaw or chew. They do not have control over the venom; if they bite, the tissue is envenomated. Coral snakes are found in the southern US from Florida to California, and they are covered by bands of red, black, and yellow–but don’t rely on your memory of rhymes to decide what it is.

Prevention

Avoid the places snakes like to be. If you need to reach into a place snakes maybe, check first. If given a chance, they will move away from you. It is when we corner a snake, and they have no escape that the problems can arise.

Signs and Symptoms

Treatment

The treatment for dry bites is the same as wounds, clean them and keep them from getting infected. For any envenomation, the patient needs to be evacuated for treatment that you can not supply. So our treatment is supportive here, treat what you find wrong, and do not worry about getting the venom out or trying to capture the snake and bring it with you. On the list of things that an ER nurse doesn’t want in the ER, that one sits pretty high. As the venom moves through the body, we will see it being damaged from the discoloration and the pain the patient reports. Remove anything in the way of swelling, rings, watches, tight-fitting jewelry. We do not want tourniquets or constricting bands for the type of snakes found in the US; we want to dilute the venom as much as possible.