WrightwoodCalif.com Forum
Public Forums => Outdoors => Topic started by: smartpatrol on Jun 04, 07, 04:51:33 PM
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My husband spotted a Western Diamondback on one of our porches today. Thankfully, we make it a habit of looking around before stepping out.
This recent sighting has prompted us to wonder. . . where do we go or who do we call if one of us gets bitten by a rattlesnake?
Thanks in advance, and I hope I never have to use this information!
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If someone gets bit call 911 or the Wrightwood Fire Department.
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August 1, 2002, issue of The New England Journal of Medicine. The article's authors estimate that between 7,000 and 8,000 people a year receive venomous bites in the United States, and about five of those people die. Some experts say that because people who are bitten can't always positively identify a snake, they should seek prompt care for any bite, though they may think the snake is nonpoisonous. Even a bite from a so-called "harmless" snake can cause an infection or allergic reaction in some individuals.....
....Many health-care professionals embrace just a few basic first-aid techniques. According to the American Red Cross, these steps should be taken:
Wash the bite with soap and water.
Immobilize the bitten area and keep it lower than the heart.
Get medical help.
"The main thing is to get to a hospital and don't delay," says Hardy. "Most bites don't occur in real isolated situations, so it is feasible to get prompt [medical care]." He describes cases in Arizona where people have caught rattlesnakes for sport and gotten bitten. "They waited until they couldn't stand the pain anymore and finally went to the hospital after the venom had been in there a few hours. But by then, they'd lost an opportunity for [effective treatment]," which increased the odds of long-term complications. Some medical professionals, along with the American Red Cross, cautiously recommend two other measures:
If a victim is unable to reach medical care within 30 minutes, a bandage, wrapped two to four inches above the bite, may help slow venom. The bandage should not cut off blood flow from a vein or artery. A good rule of thumb is to make the band loose enough that a finger can slip under it.
A suction device may be placed over the bite to help draw venom out of the wound without making cuts. Suction instruments often are included in commercial snakebite kits.....
http://www.fda.gov/fdac/features/995_snakes.html
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Ken~restricting bands, ice, cutting, suction do nothing but can cause more tissue damage. Also snake bite kits are still sold, cutting really can do more harm then good.
Best practice remember that getting to medical attention (in our area, Loma Linda is the hospital of choice) swiftly will reduce damage to tissue. Getting rings off fingers immediately is also important because of swelling. Being bit by a rattlesnake is not the most pleasant experience but shouldn't be life threatening with quick medical response. Call 911 and let the pros take care of you. If it is a severe envenomation, they will summon a helicopter to get you down the hill even faster.
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I certainly acknowledge that I personally have no experience. I copied the Information from the FDA site. I also heard the same information a few weeks back on the Keller Peak Rescue Net. The one giving the talk is an ER Doctor at Loma Linda. She was VERY careful to say that the venom travels in and effects the nervous system (? - Will one of you nurses please correct the term) not the blood. That is why the bandage should be only a loose "1 finger tight" bandage.
Again, I'm only repeating what I've been told. Even the experts keep changing their minds. ???
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While the venom affects the Nervous System, I believe it "travels" through the Lymphatic System.
Remaining calm is the best thing while waiting for professional help. Currently about 8,000 people per year in the U.S. are bitten by a poisonous snake. Out of these 8,000 people, only about 6 will die each year from the bite.
In about 30% of poisonous snake bites, no venom is injected at all. These are considered "dry bites". You'll know if venom was injected as the fang marks will begin to burn and hurt within 5 minutes and swell within 30 minutes.
First aid:
Transportation
Go to the nearest hospital emergency room as rapidly as possible. The most important part of therapy is antivenin, and it should be given within 4 hours. Lie quietly in transit to reduce absorption of venom. If the bite is on the arm, remove any rings or bracelets before swelling occurs.
Antivenin
The most important treatment for poisonous snakebites is going to a hospital emergency department as fast as possible so you can receive appropriate antivenin and other emergency treatment. Using a tourniquet should not be used. Cutting incisions over the fang marks and applying suction is no longer recommended because it is not effective.
Lymphatic band for bites on arm or leg
As Wildman suggested, this should be left in the hands of the professionals. If you are more than 60 minutes from any help, you can put a lymphatic constriction band between the bite and the heart, at least 2 inches above the bite. A lymphatic band stops lymph flow through the lymph vessels. Use a wide band such as an elastic wrap or stocking. Make it loose enough to easily slip 1 finger under it. It should not stop blood flow in the veins or arteries. If the veins stand out, the band is too tight. If the hand or foot turns white or the pulse disappears, the band is much too tight.
Never put ice on the area of the bite because ice can cause frostbite, which increases the risk of damage to the skin.
Bottom Line:
Remain calm, call 911.
Remember, Rattlesnakes are not aggressive and only strike as a defense mechanism. Spring is a very dangerous time because they are shedding and can't see as well. They lash out at anything they perceive as a threat. I've run into countless of rattlesnakes, even almost stepping on them, and NONE of them have even as much as struck at me. I give them space and they quickly leave. They don't want any part of you anymore than you want any part of them.
They do have a place in the order of things. They'll help control the current rat problem that Wrightwood is currently facing. ;D
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Lymphatic System - Thanks Robert.
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I work in the pharmacy at St. Mary Medical Center in Apple Valley, and we had a snake bite victim in our ER about a month ago (I only work part time now, so am only aware of this one, cuz I was at work that evening). The patient was a young male, bitten on the arm, I believe. The ER called us in advance of the patient's arrival to make sure we had enough antivenin available (we did).
The new antivenin (CroFab) is purportably superior to the old type, because it is of ovine (sheep) origin, much less allergenic than the former type, which was of equine (horse) origin. Those kits actually included a test sample for allergic responses, and the new version does not.
I'm sooo glad I took my tiny dog to the rattlesnake avoidance class last month - I hope we'll never need this info - but you never know up here, and this year may prove to be worse than previous years, because of the drought.....
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I agree that being calm and getting to the hospital without delay is the most important thing.
Just a word about snake bite kits. There is a new kind out that uses very strong suction without any cutting. It is called the Sawyer extractor. It might remove some of the poison, but I believe its best use is in calming down a snake bite victim (extremely important) because you are able to "do something" for them.
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Just a word about snake bite kits. There is a new kind out that uses very strong suction without any cutting. It is called the Sawyer extractor. It might remove some of the poison, but I believe its best use is in calming down a snake bite victim (extremely important) because you are able to "do something" for them.
They are not exactly new, as they have been out for a lot of years. I've bought two over the past 10 years. This is the ONLY suction device that should be used, as it sucks some of the venom back out through the original puncture wound. No cutting, which does more damage than good, is required.
I always carry a Sawyer suction device with me. They work great on bee stings also.
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The new antivenin (CroFab) is purportably superior to the old type, because it is of ovine (sheep) origin, much less allergenic than the former type, which was of equine (horse) origin. Those kits actually included a test sample for allergic responses, and the new version does not.
Thanks ForestGal for that information. Very interesting...
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I always carry a Sawyer suction device with me. They work great on bee stings also.
They do a good job on a few things, they also help or lessen the effects of sting ray venom. Good to know if you are one of the San Felipe road trippers.
However, a sting ray sting should be looked at by a MD, as the barb might still be in you. I have had a few friends get these stings, they did not look well. The best prevention is to shuffle your feet in the water at the beach, the sting rays will take off before you step on them. Now, back to rattlers.....
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Thanks for the replies, everyone! :)
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I just went through a Wilderness First Aid course this past weekend. They said not to use the Sawyer Extractor (and definitely not the old Cutter devices). They showed us some gnarly photos of snake bite victims. If you get bit, drop whatever you're doing and get thee to an ER! If I were far out but had cell coverage, I would seriously consider the helicopter option, expense not withstanding. No, snake bites are not usually fatal (for adults), but you should have seen the damage to appendages. The venom can cause necrotizing (dead flesh) that does not recover.
The other thing they said that was of note was that "light hikers" (i.e. the typical nylon mesh boots with leather trim that everyone wears nowadays) will not stop a snake bite but that all leather boots will. Something to consider in an area where snakes are active. You can get snake gaiters too, but I understand that most of them are pretty stiff and uncomfortable.
On the other hand, I've been hiking for 40+ years, and I've infrequently had rattle snakes coil on me when rock scrambling or hiking, but I've never had one do more than coil. On the trail, I'm a lot more worried about weather (especially lightning or extreme cold/heat), dehydration, and injury than I am about snakes.
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What reason did they give for not using the Sawyer Extractor (suction) device?
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Basically, they said that the vacuum force of the Sawyer Extractor actually exacerbated the tissue damage. In other words that it did more harm than good.
This is something of a surprise :o to me since I had been hearing for years, "don't cut, don't suck (with mouth), and don't use the Cutter snake bite kit but do use the Sawyer Extractor."
The "approved" method now is more like, "wash with soap and water, keep the patient calm and avoid stimulation (such as constant conversation, too many people surrounding the patient, etc.) which causes the venom to spread more quickly, and evacuate to a facility that has antivenin (AKA antivenom) capability ASAP."
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Thanks hikin_jim...
I'm not sure how I would respond to a snake bite victim after reading that new theory.
I still think that I'd use the Sawyer Extractor if it was handy and the bite had just occurred. Say within the first 10 minutes or so. I see this as a choice between removing some of the possible venom right away vs the exacerbated tissue damage.
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Here is an article by Dr Sean Bush from Loma Linda on snake bite from the Venom ER series. There are a number of interesting and related articles on this site.
http://www.llu.edu/llumc/emergency/venom-er/strike.html
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Since Wildman's last post a rattle snake victim in Lytle Creek is waiting for an airship to transport him/her to Loma Linda.
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Yipes. Please post updates about the person who got bit if you can.
Good article (two posts back from Wildman). It says:
"Do not cut across fang marks and do not try to suck out the venom with your mouth or a suction device. This could lead to complications and infections."
The article doesn't mention wash with soap and water, which they taught us in class and was also referenced in another, earlier posting on this topic. Washing with soap and water is now the recommended standard wound care (any wound, not just snake bites). Interestingly, antiseptics like Mercurochrome, iodine, betadine, etc. are no longer recommended for wounds, just soap and water. They taught us in my class that the antiseptics do kill "germs," but that they impede healing overall and shouldn't be used.
The article also states, "The majority of snakebites are 'intentionally interactive' meaning that the bite occurred when the snake was being handled, molested, or killed." This is good news from my perspective -- I have no intention of bothering any rattlers!
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Thanks hikin_jim...
I'm not sure how I would respond to a snake bite victim after reading that new theory.
I still think that I'd use the Sawyer Extractor if it was handy and the bite had just occurred. Say within the first 10 minutes or so. I see this as a choice between removing some of the possible venom right away vs the exacerbated tissue damage.
I believe the new thinking is: The venom has been injected. Any efforts to try and extract it, even partially will cause harm to the entry wound. (I have received a bruise from using the Sawyer Extractor. It's quite a "sucker".) Better to relax, get medical help and get to a hospital as soon as possible so as to let the anti-venom do it's magic.
Personally, I'd use the extractor, since I always carry it. Realistically, I don't ever plan on being bit, as I'm always careful and watchful, looking for rattlers when I hike. "An ounce of Prevention is worth a pound of cure!"
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"I just went through a Wilderness First Aid course this past weekend. They said not to use the Sawyer Extractor (and definitely not the old Cutter devices). They showed us some gnarly photos of snake bite victims."
What kind of snakes caused the bites in the 'gnarly photos'? When I lived in East Texas they said the copperheads caused the most tissue damage, that you could lose the muscel that was injected with venom. I haven't heard of that kind of damage with our local pacific rattlesnakes.
I did hear that the reason that they initially adviced not to use the 'cut and suction' kits because people were too excited after a snake bite and the victims ended up with major slashes with the razor blade. So I wonder, do the people who are recommending not to use the Sawer, just feel the general public is too incompent to use it (delaying the trip to the hospital) or is it truly a bad idea to remove the venom that will easily come out of the puncture marks. I demo the Sawyer on my arm to people on a regular basis. I find that it has strong, but resonable suction, and I have never received a bruise - just slight redness for a few minutes. I would not use it on someone with delicate skin such as a baby or elderly person. But what are the chances of that?
A great discussion is at http://gorp.away.com/gorp/health/snakefaq13.htm. Here is an exerpt "Approximately 75 percent of all snakebites occur in people aged between 19 and 30 years, 1 percent to 2 percent occur in women, and less than 1 percent occur in blacks. Approximately 40 percent of all snakebites occur in people who are handling or playing with snakes, and 40 percent of all people bitten had a blood alcohol level of greater than 0.1 percent. Sixty-five percent of snakebites occur on the hand or fingers, 24 percent on the foot or ankle, and 11 percent elsewhere.
So it seems that getting drunk and messing about snakes is a big cause of getting bitten. It also seems that male yahooism is a precursor to snake toxin poisoning. Women are unlikely to get themselves bitten, and if they do get bitten, it is unlikely that they got that way by doing something stupid. "
Reach Air Medical Services -Summer 2002 "Treat the bite site with a clean dressing. Attempts to cut, suck or remove the venom are considered to be ineffective and should not be attempted. There is one device on the market called the "Sawyer" extractor. It is a suction device which has been shown to remove some venom from bite sites if used within the first five to ten minutes of the bite. It is not common for pre-hospital care providers to have this device, but if it is available and less than 10 minutes have passed, is considered a reasonable tool to attempt to extract some of the venom. The studies from this have been somewhat controversial, but it is the only device which appears to provide any significant removal of venom from the tissues." http://www.mediplane.com/Newsletter/Archives/Summer_2002/summer_2002.html
I would love to hear a specific medical reason for not using the Sawyer immediately if it does not delay evac.
Great discussion, knowledge we should all keep in mind when choosing to live in rattlesnake territory.
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Thanks "cedar". Great information and statistics.
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There is one device on the market called the "Sawyer" extractor. It is a suction device which has been shown to remove some venom from bite sites if used within the first five to ten minutes of the bite. It is not common for pre-hospital care providers to have this device, but if it is available and less than 10 minutes have passed, is considered a reasonable tool to attempt to extract some of the venom. The studies from this have been somewhat controversial, but it is the only device which appears to provide any significant removal of venom from the tissues.
Thanks cedar as that confirms my earlier posting:
I still think that I'd use the Sawyer Extractor if it was handy and the bite had just occurred. Say within the first 10 minutes or so. I see this as a choice between removing some of the possible venom right away vs the exacerbated tissue damage.