Looking for Advice on the Unthinkable

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Fire Drake
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Looking for Advice on the Unthinkable

Post by Fire Drake »

Ladies and gents,

It often occurs to me the enormous breadth of experience there is contained in all of the people associated with this board and I have often been tempted to post a BIG question in the hopes of tapping in to that body of experience and knowledge to try and get a better understanding of something important to me and hopefully all of us. Today I am going to pull the trigger on that and fire one off. This one will be a good one because with it will invariably come a great deal of opinion along with actual experience and in this case, one is far more valuable than the other IMO. So here goes...

You are in the bush herping and spot a rocky outcropping that looks too good to pass up. While looking inside the cracks you momentarily drop your guard and place your hand down on an innocent looking spot next to you and it happens...BAM! The Two-fanged drive-by! A solid hit and likely envenomation by one of our Crotalus friends.

This does happen and each one of us knows at least one person who has been hit. But as I ponder the thought of, "what would I do..." a flood of disproven, old and possibly dangerous advice still comes to mind first before I consciously try and remember the more recent and useful information I have heard from people I trust a bit more than the average hunter of fisherman who in most cases would rather kill a snake than admire it for even a second.

What IS the best course of action? What SHOULD you do in the first moments, the minutes you will have waiting for or seeking out the necessary help that will be paramount in your survival? I at least have learned in the last decade or so that stun guns and snake-bite kits are useless if not highly dangerous. There are so many things that one COULD do but which ones will distill down and end up as good advice on this thread? Please have at it and let 'er rip. I can't wait to learn more about the 'unthinkable' moment that I hope never happens to me but could I must admit, happen at least once in my lifetime--depending on where I go and what exactly I am hoping to find.

Thanks all...
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Bryan Hamilton
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Re: Looking for Advice on the Unthinkable

Post by Bryan Hamilton »

There is not much you can do in the field for first aid. Keep the limb immobilized and at the level of the heart. Most important is activating 911 and getting to a hospital. Snakebite kits are useless and cause additional damage. If hiking out is the fastest way to get medical care, hike out.

Legitimate bites do happen but even our community they are rare. My bite was from grabbing a rattlesnake not once but twice by the tail.

Prevention, prevention, prevention. An envenomation can easily run over 100K in medical costs. Without insurance that equals bankruptcy for most of us.

A venomous snake bite is not part of being a field herper. Its no badge of honor. It makes the rattlesnakes look bad too.
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melissaisdown
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Re: Looking for Advice on the Unthinkable

Post by melissaisdown »

I concur with Bryan Hamilton that prevention and vigilance are the best ways to handle a snake bite -- that is, to never get one.

However, my 9-5 has me in a position to teach First Aid/CPR/AED training, so I know a little bit about Wilderness and Remote First Aid, and I can tell you that the manual that's used says this:

Venomous Snake Bites

Snakebites kill few people in the United States. Of the estimated 7000 people bitten annually, fewer than 5 die. Most snakebites occur near the home, not in the wild. Rattlesnakes account for most snakebites, and most of the deaths from snakebites in the United States. Most deaths occur because the bitten person has an allergic reaction, is in poor health or because too much time passes before he or she receives medical care.

What to Look For
Signals of a possibly venomous snakebite include:
■ A bite mark.
■ Pain.
■ Swelling.

When to Call 9-1-1
If the bite is from a venomous snake such as a
rattlesnake, copperhead, cottonmouth or coral
snake call 9-1-1 or the local emergency number
immediately.

What to Do Until Help Arrives
To care for a venomous snake bite:
■ Wash the wound.
■ Apply an elastic (pressure immobilization) bandage
to slow the spread of venom through the lymphatic
system by following these steps:

Check for feeling, warmth and color of the limb and note changes in skin color and temperature.

Place the end of the bandage against the skin and
use overlapping turns.

The wrap should cover a long body section,
such as an arm or a calf, beginning at the point
farthest from the heart. For a joint, such as the
knee or ankle, use fi gure-eight turns to support
the joint.

Check above and below the injury for feeling,
warmth and color, especially fi ngers and toes,
after you have applied an elastic roller bandage.
By checking before and after bandaging, you may
be able to tell if any tingling or numbness is from
the elastic bandage or the injury.

Check the snugness of the bandaging—a finger
should easily, but not loosely, pass under the
bandage.

Keep the injured area still and lower than the
heart. The person should walk only if absolutely
necessary.

■ Do not apply ice.
■ Do not cut the wound.
■ Do not apply suction.
■ Do not apply a tourniquet.
■ Do not use electric shock, such as from a car battery.

Hope that helps. Message me if you have any other questions or want to know where specifically I'm siting this from.
Lloyd Heilbrunn
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Re: Looking for Advice on the Unthinkable

Post by Lloyd Heilbrunn »

"Keep the limb immobilized and at the level of the heart."

"Keep the injured area still and lower than the
heart."

:(

So, which is it?
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BillMcGighan
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Re: Looking for Advice on the Unthinkable

Post by BillMcGighan »

Great answers and discussion.

It also should be mentioned that a high incidence of venomous bites have no or mild envenomation. Some put it as high as 20 to 25% of all bites of pit vipers. This generally is a function of the state of excitement, species, temperature, etc., of the animal.

Herpers do themselves a favor to learn as much about target species, venom virulence, symptoms, their own health history risk, etc. Urgency of response to a western Mohave would be different than an eastern Copperhead. In areas where “snakebite” is not common, ER staff can be amazingly ignorant.

Example:
A zoologist I knew handled many venomous animals with caution and no incident.
He went fishing, rolled a log for bait, and got tagged by a Copperhead. When he arrived at the ER, the attending doctor walked into the room studying two packages of antivenin: one primarily for hemotoxin, one primarily for neurotoxin.
The zoologist commented to the doctor. “You don’t know which to use, do you?”

This was probably a very competent doctor for all the trauma he normally saw, but “snakebite”…..
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Fire Drake
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Re: Looking for Advice on the Unthinkable

Post by Fire Drake »

Legitimate bites do happen but even our community they are rare.
I am sure this is true and a testament to how seriously most field herpers take what they are doing. However some of us seem to just have a bit of bad luck now and again--hence my question and use of the term "unthinkable." Things go wrong sometimes even with the best of intentions/experience/training. We are only human, after all.
A venomous snake bite is not part of being a field herper. Its no badge of honor. It makes the rattlesnakes look bad too.
Couldn't agree more and this was very well stated. We all lose when something like this happens. I will definitely take "prevention" away as one of the advisory frontrunners in this discussion. Thanks for your reply. Any chance we could learn more about your bite experience?
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Fieldherper
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Re: Looking for Advice on the Unthinkable

Post by Fieldherper »

-Cliche, but the best snakebite kit is a cell phone and pair of car keys.

-Mortality, as mentioned earlier in this thread, is extremely low for North American snakebites.

-Call 911 and wait for EMS if you can, or else have someone drive you. Driving while you are upset/stressed/panicked is a bad idea and more likely to kill you than a snakebite in North America.

-As mentioned, if you MUST hike out, then do so, but call for help as soon as is possible.

-Get to the nearest hospital. No field measures, except for the "pressure-immobilization bandage" for neurotoxic snakes (Australian elapids, American coral snakes, etc...) have been shown to help.

-If you can, call the Regional Poison Center (1-800-222-1222 no matter where you are) to appraise them of the situation. They have medical toxicologists on staff that can assist you and the treating hospital staff with the management of both native and exotic venomous snakes. If you cannot call before you reach the hospital, ask that they call when you arrive.

-If you do not have health insurance coverage, you should take great pause when considering interacting with venomous snakes. The risk of a bite obviously increases with exposure. Snakebites are very expensive and often avoidable medical emergencies for herpers/keepers.

FH
stlouisdude
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Re: Looking for Advice on the Unthinkable

Post by stlouisdude »

Ideally, you wouldn't be alone, however 90% of the time I find I am alone when herping. Ideally, you'd have cell coverage, sadly, I rarely have signal in the places I enjoy herping. So in some cases, the results might be quite bad or at least cause significant panic that something really bad might go down. Having said that, most bites are avoidable and I think that's where you can really have a big impact. Never assume that the snake you see is the only one there. With pit vipers, such is often not the case! Obviously keep your hands away from crevices and walk slowly in prairie and tall weeds likely to harbor venomous snakes. Nothing is without risk, look at nearly any medication and you'll see it could probably cause an extremely rare and serious symptom even death, but we aren't going to stop taking medicines which are overwhelmingly helpful. Likewise the exercise in herping is overwhelmingly beneficial to your health versus the tiny risk you will drop dead or go broke from snakebite.
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Fire Drake
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Re: Looking for Advice on the Unthinkable

Post by Fire Drake »

Thank you all for taking the time to comment. I value each and every opinion here. Have fun and stay safe all!!!
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azatrox
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Re: Looking for Advice on the Unthinkable

Post by azatrox »

What to do if bitten by a venomous snake while out in the boonies is a concern for all who go looking in the boonies for venomous snakes (and other critters). I have personal experience in this field, as I have been in the boonies when someone I was with was bitten. Without giving up personal info, we were in SW AZ and we were on a morning hike in a desolate area approximately an hour and a half away from any civilization whatever.

We were about a half hour into our hike when my friend spots a speckled rattlesnake. As he approaches for photos, his foot slips on the decomposed granite ledge he was standing on and he reaches down to catch himself from completely spilling out...a little too close to the snake. The snake sinks a single fang into his left thumb, and he hollers out that he's been bitten. Both myself and another friend walk with him to our trucks and proceed to go immediately to the nearest medical facility.

*One of the first things he did when bitten is take a Benadryl capsule. We also told him that if he started feeling any scratchiness in his throat to tell us immediately as this may be an indication of the onset of anaphylactic shock. We started marking off the swelling on his thumb with a marker to gauge the extent of envenomation. By the time we got to the trucks (approx. 40 minutes later), the swelling had progressed to just below his wrist, so it looked to be a mild envenomation.

After driving like a bat outta hell out of the mountains (I drove), we arrived at the medical center approximately an hour and a half later. He was in considerable pain, but the swelling hadn't progressed much. He got admitted and 6 vials of CroFab were prepared. He ended up with a delayed reaction, and his envenomation was quite a bit more severe than previously thought. He ended up spending 3 days in the hospital and using over 30 vials of CroFab. He made a full recovery, and currently suffers no long term effects as a result of the bite. I can only imagine how bad the situation could have been had he received a fully envenomated bite as opposed to a single fang.

In summary, in field actions should be as minimal as possible. No tourniquets, cut & suck, "extractor kits", etc....that's all garbage and has no business in competent field aid. In short, the best first aid is a set of car keys. Period.

Hope this helps.

-AzAtrox
dthor68
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Re: Looking for Advice on the Unthinkable

Post by dthor68 »

Best thing to do is not get bit. I have hiked a 1000 miles of SC, never worried about snakebite. I worry about mosquitoes, chiggers, ticks and horseflies, in that order. I worry about the yellow jackets when they are swarming at me. It is easy to not get snakebit, use good judgement and keep your eyes open. I am thinking that a snake bite today would cost you about $30,000 and it tends to go up frequently. If that is not a good incentive to keep your eyes open, I don't know what is.
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jonathan
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Re: Looking for Advice on the Unthinkable

Post by jonathan »

dthor68 wrote:Best thing to do is not get bit. I have hiked a 1000 miles of SC, never worried about snakebite. I worry about mosquitoes, chiggers, ticks and horseflies, in that order. I worry about the yellow jackets when they are swarming at me. It is easy to not get snakebit, use good judgement and keep your eyes open. I am thinking that a snake bite today would cost you about $30,000 and it tends to go up frequently. If that is not a good incentive to keep your eyes open, I don't know what is.
Though I myself am someone who has never even been struck at, I don't feel the claim, "It is easy to not get snakebit" has any merit. Unlikely events often appear easy to avoid to a person who has not yet had one happen yet. Too many very conscientious people have gotten bit for me to just assume that it will never happen to me. I think of Kent, who was as careful as anyone, and still got bit when a snake crawled out of a crack behind him in order to appear in a place it had not been seconds earlier. I think of the guy in the other thread who reported falling forward as he approached a snake when the granite rock under his foot crumbled off. I imagine myself walking down a narrow trail and a snake completely concealed in the long grass just to the side deciding to strike first and rattle later for once. There are too many scenarios where that chance is there for me to claim that not being bit is 100% in my control. We're talking an animal with its own unpredictable behavior here.
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JuanDowe
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Re: Looking for Advice on the Unthinkable

Post by JuanDowe »

Car keys, photo ID, a car and a satellite phone/EPIRB is the best kit.
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Fire Drake
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Re: Looking for Advice on the Unthinkable

Post by Fire Drake »

In summary, in field actions should be as minimal as possible. No tourniquets, cut & suck, "extractor kits", etc....that's all garbage and has no business in competent field aid. In short, the best first aid is a set of car keys. Period.
Once again, thanks for the replies guys. I really value all the input. I think the quote up there is (like it says-thanks atrox) a great summary of what modern best practices distill down to. I recently broke the news to my dad that stun guns being effective is not only completely wrong, but that there was evidence I had seen that the origin of that claim is actually fraudulent in nature as well. I will keep working on him as he still thinks that if purchase a snake bite kit, then it must work at least a little no matter what the method employed is. Oh well. I'll keep trying.

I have some input myself that I did not know of when I posted originally. I have limited time, but promise to post more tonight or by weekend's end. Here is a brain dump in a numbered list as an appetizer:

1. I read that there have been no known fatalities from bites by Specks. I know that this does not make it a wonderful experience nonetheless, but I would still file that under..."well that's good."
2. I also heard from a venom specialist that Specks have a weaker venom than Helleri. Again, doesn't make me want to get bit...just saying. Take the pluses with the...you know.
3. I got the wild itch to go and watch all the episodes of Venom ER on YouTube. I never watched it when it was current but sure do enjoy that show now...and wifey does too.
4. A little over 2 weeks ago the janitor at my work was bitten on the hand by Mr. Helleri (I saw the photo and know the location, there is no doubt on the sp). I will definitely elaborate on that one soon. I got at least some details that are worth sharing.

More soon. Gotta go.
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Fire Drake
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Re: Looking for Advice on the Unthinkable

Post by Fire Drake »

So the details of the bite our janitor experienced are as follows...

He was in the Yorba Linda area of Southern California near Chino Hills State Park. He was at a school and needed to move a trash bin of some sort. He reached down and behind it to pull it away from the wall and that is when he was bitten. He was able to move the receptacle away from the wall after all and that's when he saw not one, but two snakes on the ground. He was able to take one picture and then went for help. That poor guy--the first individuals he happened upon didn't believe he had been bitten by a snake. They thought he was either bluffing or just incorrect about what had happened. He eventually got attention and was admitted to a hospital where he stayed for 4 days. There is a bit of a language barrier between us so he could not tell me exactly how many vials of CroFab he needed. He responded by telling me he had 5 bags, which must have meant I.V. bags. My guess is that he probably took north of 20 vials as his bite was fairly serious and the average in North America is between 12 and 14 vials for an adult victim. As I write this, he has most of the motility back in the hand that was bitten but not all. He will make a full recovery in time though.

Just thought I'd share... And for those who are interested (like I always am) as to the fate of the 2 snakes...they got away clean. By the time anyone who believed the janitor's story made it back to the site of the bite, they were both long gone...

Cheers everyone.
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BillMcGighan
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Re: Looking for Advice on the Unthinkable

Post by BillMcGighan »

Just an addendum to this post from last year:

I stumbled onto this website that I think provides some useful reference in a succinct format:
http://www.toxinology.com/

Folks I can imagine might benefit from this:
  • … Anyone who lectures to the general public and gets those toxicity questions.
    … Anyone who is a first responder.
    … Maybe even a general medical practitioner who doesn’t encounter “snake bite” very often.
    … A herper (or just outdoors person) who may want information on their locally encountered species.
Example excerpt:
Southern copperhead
Venom
Average Venom Qty
40 to 72 mg ( dry weight ), U.S. Dept. Navy (1968) ( Ref : R000914 ).

40 to 70 mg ( dry weight ), Minton (1974) ( Ref : R000504 ).

57.5 mg ( dry weight of milked venom ), Russell (1980) ( Ref : R000464 ).
General: Venom Neurotoxins
Not present
General: Venom Myotoxins
Present but possibly not clinically significant
General: Venom Procoagulants
Possibly present
General: Venom Anticoagulants
Probably not present
General: Venom Haemorrhagins
Possibly present
General: Venom Nephrotoxins
Probably not present
General: Venom Cardiotoxins
Probably not present
General: Venom Necrotoxins
Probably not present
General: Venom Other
Unknown
Back to top


Clinical Effects
General: Dangerousness
Moderate envenoming possible but unlikely to prove lethal
General: Rate of Envenoming: Unknown but likely to be moderate
General: Untreated Lethality Rate: Unlikely to prove lethal
General: Local Effects
Mild to no pain, mild swelling, no bruising, blistering
General: Local Necrosis
Not likely to occur
General: General Systemic Effects
General systemic symptoms usually absent
General: Neurotoxic Paralysis
Does not occur, based on current clinical evidence
General: Myotoxicity
Does not occur, based on current clinical evidence
General: Coagulopathy & Haemorrhages
May cause mild coagulopathy, but pathologic bleeding not likely
General: Renal Damage
Does not occur, based on current clinical evidence
General: Cardiotoxicity
Does not occur, based on current clinical evidence
General: Other
Insufficient clinical reports to know
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