Snakebite is an oft discussed issue among outdoors folks. My guess is that about eight out of ten people are afraid of all snakes, “the only good snake is a dead snake.” It is certainly ok to be afraid of them, especially if you cannot differentiate poisonous snakes from non-poisonous ones.

With the recent flooding in some Delta areas, the Lake Washington Snake Rodeo, and numerous other summertime outdoor activities, I want to update you with some recent statistics and treatment recommendations for snakebites. Most snakebites occur between April and October. Recent estimates in emergency medicine literature and the CDC (Center for Disease Control) suggest that of approximately 45,000 snakebites per year in the United States, about 8,000 are from poisonous snakes, and these account for fewer than 10 deaths per year. 99% of poisonous bites are from pit vipers, i.e.,  rattlesnakes, copperheads, and water moccasins, and 1% from the much less common coastal coral snake. Also, approximately 30-40% of poisonous bites are “dry bites,” as the snake bites in self-defense and usually does not inject venom.

Even if you do not like snakes, you should at least be able to recognize whether a snake has pit viper characteristics, which include a triangular head, heat-sensor “pits” under the eyes, and elliptical pupils. These snakes will usually have two fangs, but occasionally a snakebite victim may have only one puncture wound from a glancing blow or from a snake in which a fang is missing. This is helpful information to the treating doctor in case you get bitten. A nonpoisonous snakebite may display teeth marks, maybe not much more than a superficial abrasion or scratch but will not puncture deeply.

So what do you do if you are bitten by a snake? Non-poisonous bites are usually associated with minimal or no pain. They are simply treated as any other superficial wound and cleaned with an antiseptic solution and antibacterial ointment application, as well as tetanus shot update.

Poisonous bites, however, are potentially very serious, even though most are not lethal. CDC says 10-44% of rattlesnake bites, though usually non-lethal, may lead to disability through soft tissue loss or amputation of body parts. The poison in a snake’s venom can cause significant local tissue destruction, and in more serious bites can cause internal bleeding, shock, and death. It is important that any poisonous snakebite be immediately evaluated by a doctor in an emergency room. In the field the victim should have the bitten arm or leg splinted to immobilize it, and he/she should be kept calm during the trip to the ER. Do not use a tourniquet as this can cause more damage than the bite itself from cutting off the blood supply to the extremity over long periods of time. A light, constricting rubber band is ok as long a pulse is felt in the wrist or foot below the band. NEVER cut and suck the bite site as old literature might suggest, as it can worsen the tissue destruction involved with the bite. Carry a snake bite kit found in most sporting goods stores and use the suction cups to apply negative pressure at the bite site to help prevent the spread of the venom. Finally, try to identify the snake. If you kill it, DO NOT handle it as dead snakes can still bite from reflexes. If you cannot physically retrieve or transport the snake, take its picture with your cell phone.

In the ER the doctor will access the victim for the amount of pain, swelling, discoloration at the bite site, as well as for any signs that the poison is spreading throughout the body. Dry bites and minor bites with minimal swelling will require the above mentioned treatment and observation for several hours before discharge home. More serious bites will be treated with antivenin. A new antivenin has been developed from sheep serum to replace the old horse serum antivenin which usually made the recovering victim sick with a delayed allergic reaction. This can also occur with the sheep serum derivative, but is usually less severe. A patient with signs of shock will be stabilized and transferred to a trauma center.

Coral snakes do not have long fangs and inject their venom by chewing it into its victim. This snake is found in Mississippi only in the coastal counties. The venom is a neurotoxin meaning it kills by attacking the nervous system of its victims. A special antivenin had been developed for its bite, but has been discontinued due to the expense of producing it and the relatively few bite encounters from this snake. Remember the pneumonic, “red on yellow, kill a fellow; red on black, friend of Jack,” as this relatively rare snake can be confused with the more common non-poisonous Scarlet king snake with similar color bands.

I’ve had the opportunity to care for several snakebite victims over the years. Interestingly most have not required antivenin treatment, and thankfully, none have died.

A couple of humorous stories come to mind. One gentleman arrived in our ER in a state of high anxiety from his nonpoisonous bite from a small garter snake. He repeated over and over that he was going to die, and nothing we could say or do would convince him otherwise. He asked for a pen and piece of paper and proceeded to write his “last will and testament” on it, and handed it to his nurse, instructing her to give it to his wife when he died. We treated his minor bite and discharged him home, with him still adamant he was about to die. I suspect that more people probably die from snake “fright” than snake “bite.”

            Another encounter involved a young man who was preparing to host a 4th of July party. He had already begun to party with “only a couple of beers” when he noticed a small copperhead in his driveway. It bit him on a finger when he picked it up to relocate it from the party area. He told us, “I was afraid someone might hurt the little fella!” He needed no antivenin and was discharged with a diagnosis of “alcohol induced snakebite!”

Another bite victim was a man training his black lab to retrieve ducks in the summer using a training dummy. His dog suddenly seemed to be hung in an underwater brush top, and he paddled over to it to free him. As he reached under the lab to lift him into the boat, he felt a sharp pain in his hand. Inspection showed he had two puncture wounds close together and realized he had been bitten by an unseen cottonmouth, which can definitely bite underwater, in case you were wondering. This victim spent several hours of observation in our ER showing only mild swelling in his hand., required no antivenin, and was discharged home.

            Remember to always beware of snakes, even in cool weather. While turkey hunting, I have encountered a timber rattlesnake on a cool morning in south Mississippi, a six-foot Eastern Diamondback rattler in south Florida and a similar sized Western Diamondback rattler in south Texas. And I once dispatched a cottonmouth moccasin in twenty-degree weather in January in Issaquena county on a rabbit hunt.

An excellent full color snake identification app to have on your cell phone was created by herpetologist and Professor Emeritus of Ecology at the University of Georgia, Whit Gibbons. Snakes of the Southeast is a wonderful ID app to have in the woods.

So, watch your step and where you put your hand when on your outdoor adventures. Be Safe!

By Bobby Dale, January 26, 2021

Snakebite originally appeared in Delta Wildlife Magazine