When it comes to snake bites, many of us have a common belief that sucking the venom out, tying a tourniquet, or cutting the bitten area will reduce the effects of a snake bite. However, the reality is vastly different, according to Spencer Greene, Director of Toxicology at HCA Houston Healthcare-Kingwood and founder of the Bayou City Medical Toxicology and Emergency Consultants.
With summer upon us, and snakes on the move, Liberty-Dayton Regional Medical Center on Thursday, May 18, hosted a free seminar at the Hartel Building in Liberty regarding the medical treatment of envenomation patients. For LDRMC employees, participation in the class was mandatory, though only a handful attended in person and the rest attended by Zoom. Larry MacNeil, Community and Partnership Liaison for LDRMC, said that hospital administrators felt that the class was vital training for the hospital’s nursing staff.
In the class, Greene began by saying “People perpetuate a lot of misinformation, and a lot of myths about snake bites. It’s actually a real barrier to providing good care.”
For example, the saying about coral snakes – ‘Red and Yellow Kill a Fellow’ – is actually untrue most of the time. One snake bite myth is that baby snakes are more venomous because they lack the control of older snakes.
Dr. Greene talked about four major venomous snakes in the Southeast Texas area. Three of these four are considered pit vipers, meaning they have a pit halfway between the nostril and eye where a thermoreceptor is located. Pit vipers account for 98 percent of the snake bites in the United States.
The first of the three is an Eastern Copperhead, which accounts for about 75 percent of the snake bites in the area. The second is a water moccasin, also known as a cottonmouth. These account for 15 to 20 percent of local snake bites.
In Southeast Texas, there are several rattlesnake species, the third pit viper. The most common is the timber rattlesnake, which Benjamin Franklin actually recommended to be the national animal before the bald eagle was ultimately chosen. The timber rattlesnake is responsible for more deaths from snake bite than any other species of snake in the United States.
A few features you would want to look for when identifying a pit viper is a really large, triangular head, skin pattern, eye shape and size, and the fangs, which are long and mobile. When identifying a snake, using more than one feature is advised, because some nonvenomous snakes can flatten their heads out to look triangular and some pit vipers who have head trauma have dilated pupils, making them look round instead of the normal vertical, sharp pupils.
Greene advises, “The best rule of thumb is if you don’t know what the snake is, don’t mess with the snake.”
The last local snake that Greene talked about is the Texas coral snake. The major misconception about the Texas coral snake is that ‘red and yellow kill a fellow’.
“I can count on zero fingers how many people have died from a Texas coral snake bite in the last 50 years. Zero fingers,” Greene said.
Also, not every Texas coral snake has red and yellow touching, or red and yellow on their body at all. In Southeast Texas, they are the second most painful venomous bite, behind the black widow.
“The pain is really bad, and you feel like you’re going to die, and you want to die, but no one has ever died from a Texas coral snake,” he said.
A startling statistic mentioned in this seminar is that only about 19 percent of snake bites are due to intentional interaction, and the other 81 percent are from a surprise snake. Greene recommends to not wear flip-flops and shorts when you walk your dog at night.
If you do happen to get bitten by a venomous snake, there are a few recommendations to maximize your recovery and make healthcare professionals’ jobs easier.
A list of things NOT to do in the event of a snake bite:
- Sucking on the snake bite in an attempt to remove the venom not only doesn’t work, because of how quickly the venom enters the bloodstream, but can actually harm both the victim and the person sucking out the venom.
- Using a tourniquet to try and stop the spread of the venom is ill-advised. Because, in 95 percent of snake bites, tissue damage is the biggest symptom of a snake bite, causing further damage to circulation by using a tourniquet. It can be incredibly harmful and can run the risk of limb loss.
- Using an extraction device, like one marketed for personal use in an emergency situation, is similar to sucking out the venom. They almost never work.
- Do not transport the snake to the hospital – dead or alive. Avoid contact with the snake carcass because even a decapitated snake head can kill someone, as was seen in a case in South Dakota where a man died from contact with a dead snake’s head.
- Benadryl or an EpiPen also will do nothing to help a snake bite, and both can actually have harmful effects.
- Dr. Greene doesn’t recommend ice packs because people are not as responsible for an ice pack as they should be in an emergency situation. Using an ice pack can be beneficial for pain management in the event of a snake bite, but for intervals of 5 minutes on the snake bite site and 10 minutes off. Any longer than this can severely damage tissue in the affected area.
A list of things recommended by Dr. Greene TO DO in the event of a snake bite:
- Ensure everyone’s safety. The last thing you want in the event of a snake bite is another snake bite.
- If someone can safely take a picture of the snake from a far distance and quickly, it is beneficial for the healthcare staff to treat the snake bite.
- Position the affected body part correctly, which is at or above heart-level, and unbent. For example, if you have a bite on the hand, you will want to elevate the hand at or above heart-level, with elbow and wrist unbent. If the elbow is bent, it affects blood circulation, which further damages the tissue in the bitten area.
- Remove jewelry from the affected body part before possible swelling begins.
- Get to the appropriate hospital as soon as possible. Dr. Greene recommends the hospital where he oversees the snake bite treatment, HCA Houston Healthcare-Kingwood. The rate of recovery is at its highest – 0 to 6 hours after the snake bite.
