Why did it have to be snakes

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Snakes. Why’d it have to be snakes?

Probably everyone who has gone on a nature hike or a stroll through the woods has thought about snakes. What would you do if you were bitten by a snake? Do you have one of those snake bite kits available in the drug store? I'll tell you why I don't further on in this post!

Poisonous Snakes?

Trick question: how many poisonous snakes are there in North America? The first thing you need to know is: There is a difference between poisonous and venomous. Poison is secreted and primarily defensive. In the case of animals it is usually not produced by the creature itself, but sequestered from the environment. Venom, on the other hand, is intended to be injected by fangs, stingers, or other structures. It is primarily offensive, being used to disable prey before consuming. Further most venoms are harmless if ingested, which means that most rattlesnakes can be eaten safely. However, there are exceptions so don't go out eating rattlesnakes and cobras based on something you read on the internet!

Keeping that in mind, you might think that there are no poisonous snakes in North America; that some are venomous but none are poisonous. You'd be wrong though. I did say it was a trick question, didn't I? Thamnophis sirtalis, the common Garter Snake, has a nerotoxin, venom, it uses to disable prey. It also stores tetrodotoxin, poison, from newt prey in it's body to ward off predators².

So, if anyone ever asks you how many of the ~3150 species of snakes in the world are poisonous, you can give them an answer of at least four species³

Three of the four species are found in North America, by the way.

Types of Venomous Snakes in North America

I mentioned above that Thamnophis sirtalis is venomous. Thamnophis sirtalis is known more commonly as the Garter Snake. You may have heard that Garter Snakes are not venomous. While they pose little danger to humans, Garter snakes do have a venom that they produce in Duvernoy's gland and inject through rear fangs into their prey. The venom is not dangerous to humans⁴. The species belongs to family of snakes called Colubridae. Colubridae represents an intermediate stage between non-venomous snakes like pythons and true venomous snakes like vipers and cobras. Some are non-venomous, some have Duvernoy's glands but no fangs to inject the venom. Others, like Thamnophis sirtalis have rear fangs to inject the venom⁵.

The four most common types of venomous snakes in North America are: rattlesnakes, copperheads, cottonmouths, and coral snakes. Cottonmouths are often called water moccasins. Along with the water moccasins, rattlesnakes and copperheads are pit vipers. They can be distinguished by the "pits" or heat sensitive glands under their eyes⁶. Most pit viper venom is classified as hemotoxic. Hemotoxin symptoms include intense pain, swelling, edema, and sometimes vomiting and confusion⁷. It's usually hard to ignore a bite from a rattle snake or water moccasin, even if you didn't notice the initial bite.
By contrast, coral snakes have neurotoxic venom. Often the venom causes the bite site to become numb, as well as causing weakness near the bite site, sweating, salivation, and sometimes paralysis⁸. Many people don't notice a coral snake bite until hours after being bitten. This is because their bites are usually painless and because they often hide in piles of leaves. Coral snakes look similar to king snakes, with red, yellow, and black stripes. In coral snakes the red and yellow portions touch each other. In king snakes the red and black stripes touch and the red and yellow ones do not. There is a simple rhyme to remember which is which[^6].

Red on black, safe for Jack
Red on yellow, kill a fellow!

Treatment for Snakebites

Over %90 of the snakebites in the US are from pit vipers, rattlesnakes, cottonmouths, and copperheads⁹. Snakebites are not automatically fatal, but often require treatment at a hospital or other emergency medical facility. For any suspected snake envenomation, the best course of action is activation of emergency medical services and prompt transport to an emergency department. Modern emergency departments often have anti-venom on hand, as well as other interventions that greatly increase the likelihood of a positive outcome and recovery. Misinformed first aid measures do more harm than good. Simple first aid that you would do for any wound is the best thing you can do after calling EMS/911.

What Not to Do!

In the past, there were many snakebite specific cures and treatments offered to hikers, travellers, and the general public. Most of them are actually worse than no treatment at all! Here are some things you should never do if you or a companion has a snakebite:

Tourniquet Because pit viper venom causes severe swelling and is hemotoxic, meaning it damages the blood, tourniquets were suggested to cut of the blood flow and prevent spreading of the injury. However this isolates the toxic blood in the affected area, leading to more damage to the local area while not preventing the spread of poison much. In severe cases, limbs had to be amputated because a tourniquet had been applied.

Electric shock I don't know how this idea got started, but in no case should you shock a snake bite with a stun gun or any other electric device.

Cut into the wound If the damage is due to venom from the snake bite, then sucking it out makes sense right? Wrong! Numerous studies have shown that making incisions to "suck out the venom" greatly increases the risk of infection. Some experts still state that "a venom extractor can be beneficial if applied within five minutes of the bite and left in place for 30min"¹⁰ More recent research has shown that this may actually be harmful. My recommendation is to NOT use suction devices at all!

The other thing that you should not do is try to capture or kill the snake.

You obviously do not want a second bite. Snakes are quick, and if they feel threatened they are more likely to bite. Even if the snake is dead, muscle reflexes can cause it to bite and inject venom.
Any time spent looking for, capturing, or killing the snake is time that is not spent getting help.

First Aid for Snake Bites

The most important first aid for venomous bites is transport to an emergency medical department. This means calling 911 or other EMS services and preparing the patient for transport. It can also mean transporting the patient yourself if you are out of reach of EMS. The quicker that you get the patient to an emergency department the better their odds of recovery are.
Here are the steps to follow if you or someone you know is bitten by a venomous snake:

Call 911 or other EMS immediately.
Immobilize the affected limb, keep it still. Also keep the limb below heart level if at all possible.
Clean and dress the wound as a normal wound. Use clean water and clean or preferably sterile dressings/bandages.
Minimize activity of the patient. Keeping the patient calm and still will lower heart rate and breathing which will slow the spread of the venom and minimize damage.
Apply a loose band between the bite and the trunk (proximal). Use a wide, flat band and make sure that two fingers can fit comfortably between the limb and band. If in doubt, or equipment is lacking, it is better to skip this step than to make it too narrow or too tight!

After all the above has been done and if it is safe to do so you should attempt to identify the snake from a distance. All you will need is a description of the colours, scales, and head shape to help an expert identify the snake. In the age of cell phones with high res cameras, I suggest taking a picture from a safe distance. Remember: never delay transport of a patient to identify the snake.

Coiling it all Up

Hopefully you will avoid any snake bites on your forays into nature; but if not, now you know what to do if you get bit. Remember these key facts, because knowing is half the battle (thanks G.I. Joe!).

Venom is offensive and venomous snakes don't eat humans, so stay out of their way and you'll likely not get bit.
Coral snake bites may not be painful immediately, but can still be very serious.
Call 911/EMS for any known or suspected venomous snake bite.
Don't use tourniquets, stun guns, razors, or suction on a snake bite.
Keep your distance from the snake to avoid a second bite.
Keep calm, apply basic first aid, and get to a hospital ASAP!

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