Are snakebites dangerous? How to treat ⛑ a venomous snake 🐍 wound

Well, since @papa-pepper is the resident snake expert, I wanted to write this little admonishment to him about snake bites, especially from copperheads.

Basically, snakebites hurt, but they are not usually life-threatening where he lives.

This advice is for those in the United States where copperheads, cotton mouths, and rattlesnakes are the dominant poisonous snakes. This advice is therefore targeted to North American snakebite victims and their caregivers, and it is current as of 2017.

I knew a girl who was bitten by a snake about 2 years ago. I will call her Jenny (not her real name). It was a copperhead bite on the foot. I wanted everyone to understand that venomous snakebite is not super common, but it is one of the most harrowing experiences a child can have.

Why? Because her parents are going to have to respond. And when they do, God help them all, because it’s likely that they will make some mistakes.

My best recollection of Jenny's situation is that every single thing recommended and suggested and selected to do for poor Jenny… was wrong. All of the old first aid rules of venomous snakebite have been revised by the medical profession it would seem! Jenny’s parents felt so bad after the incident. They are not alone. Snakebite care has changed a lot in the last 50 years!!

Please don’t guess and try to remember what to do from First Aid school!

First off, do not panic. Do not upset the child (or patient). She does not need extra blood flowing and extra concern. She needs to remain calm. Parents, please just settle down and take some advice. Pass along soothing, calming things to your child who is hurting right now.

Second off, there is good news. Copperheads are so small and so disinterested in human flesh that they very rarely administer a deadly bite. The “dry bite” is common with copperheads.

In other words, little or no venom may have entered the bloodstream.

Statistically, the annual snakebite death rate in the US is around 1 per 65 million people. Source: https://www.cdc.gov/niosh/topics/snakes/ “It has been estimated that 7,000–8,000 people per year receive venomous bites in the United States, and about 5 of those people die.” That’s about a 1 in 1,400 rate.

Copperhead bites are not particularly dangerous. They are poisonous pit vipers, yes, but their bites are often impotent. Just calm down. There is a good possibility that even without medical care, the child will be fine! I am saying this in case you are far from a medical facility, and the anxiety is getting to you, and in your haste you will just do something worse than the bite.

Stop reading and calm down (a) yourself, (b) the child (patient), and the (c) parent or primary caretaker.

Ask bystanders to keep quiet for a few minutes and watch the child. Everyone needs to start using their power of observation, and all of the distractions need to be eliminated.

Now that you are able to read the rest of this article with some peace and quiet, do these things if you are caring for the child:

1. Everyone involved needs to remain calm and cheerful and lighthearted.
2. Identify the wound by looking for it… It may be 2 small punctures or a cut
3. Have the child (patient) sit or lie down, keeping the wound below the heart … for gravity’s sake
4. Remove clothing or jewelry 💍 in the area around the wound… in case it swells
5. Clean the wound. The snake had a dirty mouth… Use an alcohol swap or soap & water.

Do these things if you are overseeing the emergency:

1. Remain calm and cheerful and lighthearted
2. Find out the type of snake as long as it is safe to do so
3. Call for medical attention or arrange for transportation to a medical facility
4. Make sure the caregiver is keeping attention on the wound and child

My advice, not based on the medical literature:

1. Pray for the child and her healing
2. Have the child or patient take some anti-inflammatory and pain medicine

Never do these things. These are often suggested, but are not acceptable first aid procedures.

1. Do not administer a tourniquet (this is used for a different type of injury)
2. Do not use ice or cool the wound (it is bad advice for snakebite, can worsen outcome)
3. Do not apply heat to the wound
4. Do not assume that the bite will cause swelling, damage, or infection (it may be a dry bite)
5. Do not use an old snakebite kit 💼 suction device (This device is worthless, see 2004 study*)
6. Do not suck on or cut the wound. Cover it with a light bandage. (because germs)
7. Do not assume that antivenom 💉 will be the only cure for the bite. It’s very expensive and not generally needed. It may not be a covered expense with your health insurance.
8. Do not assume that an ambulance ride 🚑 will be the best option for the child. This in itself is traumatic, may be costly, and may be unnecessary. This option may separate the caregivers from the child and cause more anxiety than care.

And if you want to get really involved in medical controversy, here is some questionable advice:

1. If you are unable to get the child (patient) to a medical facility, and there are indications that the wound contains venom, there may be some improvement by using “pressure immobilization” or “pressure bandaging.” This type of bandaging is subject to high error rates in human patients, and is therefore highly discouraged. Applying the bandage too loosely is a common error. However, applying the bandage too tightly can function as a tourniquet and cause more damage. Since this is highly discouraged in the medical literature for North American snakebite, I have chosen not to explain how this works. If you need to know this technique, you should probably contact a medical expert.

OK, now back to Jenny. Little Jenny survived with all the wrong first aid care and no medical intervention. She didn’t get an ambulance ride; there was no antivenom administered; and except for some moderate pain and minor swelling, she was fine.

I think the best thing we all did for Jenny was to care for her, pray for her, and keep her safe. Jenny’s parents learned some valuable lessons. Please learn from their mistakes.

Sources and links:
Primary source: My observation of a snakebite victim’s care, circa 2015 or 2016.

Pressure Immobilization After North American Crotalinae Snake Envenomation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550191/ J Med Toxicol. 2011 Dec; 7(4): 322–323.

Snakebite advice: http://arachnophiliac.com/burrow/snakebite_advice.htm

WebMD advice: http://www.webmd.com/first-aid/snakebite-treatment

CDC advice: https://www.cdc.gov/niosh/topics/snakes/symptoms.html

*Why you shouldn’t suck out venom with a snakebite kit pump? It doesn’t suck out venom.

• From https://www.ncbi.nlm.nih.gov/pubmed/14747805 “The Sawyer Extractor pump removed bloody fluid from our simulated snakebite wounds but removed virtually no mock venom, which suggests that suction is unlikely to be an effective treatment for reducing the total body venom burden after a venomous snakebite. The Sawyer Extractor pump removed bloody fluid from our simulated snakebite wounds but removed virtually no mock venom, which suggests that suction is unlikely to be an effective treatment for reducing the total body venom burden after a venomous snakebite.” - Suction for venomous snakebite: a study of "mock venom" extraction in a human model. Ann Emerg Med. 2004 Feb;43(2):181-6.

Warning: this article does not apply to any other region or continent where other types of poisonous snakes are known to cause different types of injury. North American poisonous snakes are benign compared to venomous snakes indigenous to other regions. This article does not apply to other types of venomous creatures.