HOUSTON
Warmer weather coaxes snakes out of hiding, and it’s important to know what to do after a snake bite, according to a medical toxicologist at Baylor College of Medicine (www.bcm.edu). “Many people don’t realize how much of an issue snake bites are in this area of the country,” said Dr. Spencer Greene, director of medical toxicology and assistant professor of medicine – emergency medicine at BCM. “In fact, our regional poison center reported 235 snake bites – including 148 from known venomous snakes - in the Houston area in 2012, and I am sure many more are going unreported”. According to Greene, the first step is avoidance. “Never reach into a hole or a bush blindly, a snake may be resting there,” he said. “It is also important to maintain an appropriate distance from a snake. Most pit vipers, which include rattlesnakes, copperheads and water moccasins, can strike at a target up to two-thirds of their body length when provoked.”
If you are bitten by a snake, Greene suggests the following important steps:
•Stay calm.
•Call 911 immediately to be evaluated.
•Take off anything that is constricting the affected area, such as a ring or watch.
•Position the affected area at or above heart level. This means that if you are bitten on the hand, bring it to heart level, and if you’re bitten on the leg or foot, elevate it if possible. This minimizes the amount of local tissue damage and swelling, which is the most common finding in pit viper bites.
•Go to the emergency room – the sooner the better.
Greene also dispels several myths about treating snake bites and suggests heeding the following advice:
•Do not apply a tourniquet or a constriction band.
•Do not apply ice; it can cause local tissue damage.
•Do not apply heat.
•Don’t cut the affected area and attempt to suck the venom out – this increases the amount of local tissue damage.
•Don’t use a commercially-available extraction device. These have also shown to be ineffective in removing venom and actually increase the amount of tissue damage.
•Don’t use electrical therapy.
•Don’t apply any type of lotions or ointments.
The management of snake bites has changed over the years and the newer type of anti-venom has proven to be very effective in reducing pain, bleeding complications, swelling and tissue damage, Greene says. Although anti-venom has been shown to have the maximum effectiveness within the first 12 hours of the bite, it can still be effective a few days after the bite. At the hospital, physicians will determine if anti-venom and hospital admission is necessary. “Ideally, patients should be evaluated by a medical toxicologist with experience in managing snake bites,” Greene says. If a patient requires anti-venom, he or she usually spends one or two days in the hospital. After hospital discharge, patients will need to follow up twice a week for two weeks to watch for any signs of recurrent toxicity.
