Over the years there have been many in-the-field remedies for snakebites. Most of these therapies are as strange as our fear of snakes, and none of them work. Mostly, they increase the harm that is already being done.
I remember a few encounters I have had over the years. One encounter was while foolishly hopping down some rock ledges in ponderosa-pined forest on a warm summer day. It was rather brief and seemed to happen while I was in midair between two of the ledges. Luckily some smaller rocks had fallen preceding my leap, startling a timber rattler just in time to prevent me from making him into a welcome mat. As he hurried away, I stood there stunned for a few moments with the sound of his tail still in my mind. For awhile after, I fooled myself into thinking that I would hear a warning rattle if I were ever approaching snake territory. The truth is many snakebites occur without a warning. Still, I make a good habit of kicking loose rocks and scree over ledges before I step.
Our fear of snakes is disproportional to the likelihood of being bitten. Their creepy nature only enhances our fear. Looking at some numbers helps put the risk in its place. Native, venomous snakes are found in every state except for Alaska, Maine, and Hawaii. Each year in the U.S. approximately 45,000 snakebites are reported. Of these, only 8,000 are deemed to be from poisonous species. One retrospective study in Utah identified only 9 poisonous snakebites per year that resulted in actual signs of envenomation. Even then, only five or six people die each year from envenomations, nationwide. Now that doesn't mean you are completely free from worry. Those 5 or 6 people are the ones that didn't get to the hospital, didn't receive enough treatment, or are the very young and very elderly who are more susceptible to the damaging effects of the toxins.
Does it strike you as interesting that the victim profile is mostly men between ages 17 and 27? How about that alcohol intoxication is a risk factor for being bitten? Or that the most bites occur in the peak summer months? I'm having a vision of a drunken young male messing around with an angry snake on a hot day. In this case who is more intelligent? I'd bite him, too. Most outdoor places where I've been, people want to throw little rocks at a snake or poke it with a stick to see what it does. I'm guilty. However, trying to upset a snake is a stupid thing to do. Just walk away. Take a picture if you need to, but do it from a safe distance.
Some snakebites are just accidental. If I had landed on that snake I would most likely have been a victim. But strangely, some snakebites are "dry," meaning no venom is injected. Some studies have shown that 25% of rattlesnake bites and 50% of coral snake bites are dry. Good luck guessing whether you’ve been struck with poison.
I don't have room here to include all of the pictures and descriptions of the 25 indigenous, poisonous snake species in the U.S. If you go hiking in snake infested country, take a herpetologist. You'll probably learn a lot. If herpetologists are scarce, you can try to identify the snake yourself. It can be hard. Some general rules apply.
We hear most often about pit vipers (e.g. rattlesnakes, copperheads, and water moccasins). Their name comes from the heat-sensing "pit" on each side of their face that might make it look like they have four nostrils. They have heads that are more triangular than their non-venomous cousins, because of the extra room needed for venom glands. They have oblong or slit-like pupils, if you happen to have 20/10 vision from afar or you're looking at a dead one up close. Retractable fangs fold up into their mouths when closed. Many have rattles, but not always.
Coral snakes live in the Southern United States, but none are native to Utah. In case you travel south, here's the low down. These snakes are shy night creatures with smaller heads. They are not aggressive, so most bites here fall into the non-accidental category. They have alternating bands of race-car colors: red, yellow, and black. There are some non-poisonous snakes that try to impostor this color scheme. This gives rise to some of the rhymes used to remember who's poisonous and who's not. The simplest of these is, "Red on yellow can kill a fellow."
Within roughly 30 to 60 minutes you might notice swelling, redness, and bruising around the immediate bite site. The victim may also complain of burning pain.
Since you're reading this article, maybe the next time you're out and see a snake you'll know what to do. However, your friend may not be as fortunate. Let's say he's takes a hit of the bad medicine on his hand. Now what? Hopefully you were able to get a good description of the criminal before he ran away. Some people recommend killing the snake to have the body for identification. Unless you have a really good way of doing this, I recommend you let it go. A word of caution: snakes can still strike by reflex even after they are dead for a few minutes. Of course, having the snake’s body will not change how much venom has or has not been injected. This is when you might wish you had that herpetologist nearby for reassurance with identification. Since you don't, you must assume you now have a medical problem on your hands.
You'll have to rely on signs and symptoms and it can be tricky. The initial response to most snakebites is a feeling of utter doom or panic. Even without envenomation, people can get emotionally unstable or, conversely, withdraw and quietly prepare to die. Fear may make them become pale, clammy, and lightheaded. They might become nauseated and vomit. A fast heart rate and confusion could also occur from stress and fear alone. The best thing you can do is put on your cool, calm demeanor that exudes confidence and skill as you help him or her to the nearest medical facility. Current science shows there is very little else you are going to do that will help save the day.
Since behavior is not a reliable measurement in this situation, here are some more objective signs you might notice on the way out. Within roughly 30 to 60 minutes you might notice swelling, redness, and bruising around the immediate bite site. The person may also complain of burning pain, but not always. The initial phase of the reaction is very local, but depending on the severity of envenomation it can progress to affect all systems of the body. Effects most commonly seen are nausea, vomiting, numbness and tingling around the mouth and in the fingers and toes, muscle twitching, tiredness, and weakness. In the worst cases the victim will have difficulty breathing properly, develop a blood pressure that is too low for the vital organs, and may even develop spontaneous bleeding.
An exception to this is coral snake venom. It may not produce any local effects until systemwide signs and symptoms occur, when the person may need mechanical ventilation to save their life.
With this confusing array of effects and the difficulty of knowing if, when, or how bad things will get: evacuate. Poisonous snakebites are a true medical emergency.
Over the years there have been many in-the-field remedies for snakebites. Most of these therapies are as strange as our fear of snakes, and none of them work. Mostly, they increase the harm that is already being done. Even if you were told to do these in the past, DO NOT use tourniquets, incision and suction, ice, or electric shock. Things you SHOULD DO include stepping away from the snake, removing any jewelry or constrictive bands/clothing, reassuring the victim, noting the time the bite happened, and get moving to the hospital.
At some hospitals, there are anti-venom medicines to stop and possibly reverse the progression of the envenomation effects. These are serious medications that play tricks on the immune system. They need to be monitored at the hospital, as well. Time is of the essence--these work best if given within the first 4 hours, but you probably shouldn't be making the victim run to get there. A large increase in blood flow might shorten the time until systemwide effects occur.
Avoiding the snakebite from the start just seems to be the best approach. Follow these general tips: Leave snakes alone. Don't try to kill snakes. Stay on trails. Stay out of high grasses; they hide snakes really well. Wearing leather boots might prevent a few bites. Don't put your arms and legs where you can't keep track of them. Some experts say a snake can strike half its length. If you see one, double or triple that distance for a margin of safety.
So, what are the most important lessons? All snakebites should be treated as serious medical emergencies. Forget what your scoutmaster taught you about treating the bite and get to a hospital. And, strongly consider not playing with snakes.
Hopefully, you've learned a little about confronting snakes in the outdoors. If you haven't already, sooner or later you'll see one of these critters on one of your adventures, but this time you'll know better what to do.