Snake Bite

In 2015 we provided medical support for the Primal Quest Expedition Race. It included a 600 foot ascent up Calaveras Dome. However, fear of falling wasn’t the issue. It was fear of rattlers which were prevalent in that area. Happily, no bites, probably because the racers were distracted and too fatigued to try to play with them.

For whatever reason, men seem to be at much greater risk than women, and upper extremity bites seem more prevalent than lower extremity bites. It’s a mystery.

You’ll find many pages in wilderness medicine text books dedicated to snake identification. “Red on yellow kill a fellow, red on black venom lack.” However, that’s neither here nor there for me. I’m dazzled by the way they move, and feel no ill will towards them. But I’m still quite happy to keep my distance.

Red Flags:

• Immediate symptoms
• Punctured skin
• Light headed or unconscious
• “Metallic taste”
• Previous bites (yes indeed)
• Rapid local swelling and bruising

Happy Words

• Scratches in the shape of a horseshoe bite
• No symptoms
• No problems hours since bite
• “I didn’t hear a rattle, head was round, no pit, two rows of scales under the tail, and round pupils” (yeah right)

Sprinting to the nearest hospital isn’t recommended for fear of circulating venom faster. But if a venomous bite is suspected, then transport ASAP to anywhere with anti-venom is still top priority. While waiting for transport, keep the bitten extremity low and irrigate if possible to wash away any venom, dirt or bacteria. However, no slicing, sucking, squeezing or tourniquets. A light pressure dressing to limit lymphatic flow may be useful.

Lastly, no need to apprehend and kill the snake to bring with you to the hospital. Crofab antivenom is useful for the majority of bites in the US (rattlesnakes, cottonmouths, copperheads). Bites in India and Australia are another game. If you’re a snake handler, keep this in mind and do not call Pre-R. Actually, I take that back. If you’re a snake handler interested in an EpiPen or a couple vials of Crofab ($6300), then maybe we can help. Telemedicine only.

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