• Hemotoxic venom affects the circulatory ystem (heart and cardiovascular system).
• Neurotoxic venom affects the nervous system and brain.

ALABAMA POISON CENTER
2503 Phoenix Drive
Tuscaloosa, AL 35405

Emergency Phone: 1-800-222-1222

If the victim has collapsed or is not breathing, call 911.

Administrative Phone: (205) 345-0609

FAX: (205) 345-7189

Website: www.alapoisoncenter.org

 

 

What To Do If Bitten by a Venomous Snake

• Get to the nearest hospital as soon as you can

• Remain calm and call for help.
• Restrict movement as much as possible and try to keep the wound below the level of your heart. This will reduce the spread of venom.
• Take off any jewelry or tight clothing near the bite before swelling starts.
• Try to remember what the snake looked like: its color, shape and markings. This will help with your treatment.
• Cover the bite with a clean, dry bandage.
  

• Get to the nearest hospital as soon as you can.

• Allow bite to bleed freely 30 secs.
• Use Sawyer Extractor (see below) for 15 secs to 1 minute over both fang tracks
• Cleanse and/or disinfect bite area throughly if possible
• Apply hard direct pressure over bite using a 4 x 4 gauze pad folded in half x 2
• oak gauze pad in Betadine(tm) solution if available if not allergic
• Strap gauze pad tightly in place with adhesive tape
• Overwrap dressing above and below bite area with ACE bandage
• Wrap ACE (elastic) bandage as tight as one would for a sprain. Not too tight.
• Check for pulses above and below elastic wrap; if absent it is too tight
• Immobilize bitten extremity, use splinting if available
• If possible, try and keep bitten extremity below heart level or in a gravity dependent position
• Go to nearest hospital or medical facility as soon as possible

 

What NOT To Do If Bitten by a Venomous Snake

What to Avoid	Reason Why
DO NOT physically exert yourself beyond what is necessary to get to a hospital	Doing so will increase blood circulation, speeding the spread of the venom beyond the area of the bite.
DO NOT take any kind of medication.	Medications of any kind, including aspirin and vitamins, may cause unexpected reactions with the venom. Also, many medications, such as aspirin and other pain-killers, thin the blood and speed up the heart.
DO NOT eat or drink anything unless advised by medical sources	This will facilitate a more accurate diagnosis at the hospital. Of course, common sense should tell you that if you are out in the middle of nowhere fluids will be necessary to avoid dehydration.
DO NOT drink alcohol.	Alcohol thins the blood, impairs judgment, overworks the kidneys, and stresses the entire body.
DO NOT cut the place that has been bitten or try to suck the venom out of the snakebite.	Self-surgery (i.e. cutting yourself open) is highly dangerous. An incision that is too deep or misguided could sever nerves (causing permanent paralysis in appendages) or cause massive bleeding. Oral suction or the use of another suction device (as in pellet-shaped snake bite kits) provides inadequate suction to extract venom. In fact, strenuous oral suction can prove physically exhausting and stressful, thus actually worsening the effects of the bite. Evidence suggests that the application of a product called The Extractor does NOT provide any benefits, and may actually cause worse necrosis at the site of the bite.
DO NOT apply a constrictive tourniquet, or try to stop the blood flow to or from the snakebite.	Constrictions of any kind, even shoes or watches, may stop adequate blood flow. Even the tissues around a snake bite require oxygen! While the proper application of a tourniquet will not stop blood flow, in such a stressful situation it is difficult to apply and monitor a tourniquet. As the area around the wound swells, the tourniquet would require almost constant adjustments. In short, tourniquet are too complicated, too dangerous, and don't work anyway.
DO NOT apply hot or cold packs, or ice.	Heat may cause blood to flow into the snake bite area, thereby causing the venom to spread more rapidly. On the other hand, cold may reduce the diffusion of the venom too much, thereby causing greater localized tissue damage.
DO NOT apply electric shock of any kind.	Studies show this does NOT retard or reverse the spread of venom.
DO NOT kill or capture the offending snake to bring with you to the hospital. You may put yourself at risk for a second bite in doing so.	The antivenin for pit viper bites is the same for all species so identification is rarely necessary. Emergency room personnel will know from the type of bite (punctured versus chewed tissue) whether the attacker was a pit viper or coral snake.

 

• Species (and even geographic location) of snake involved
• Size of snake
• Amount of venom injected
• Size and overall health of bite victim
• Location and depth of bite
• Physiology of bite victim
• Reaction of bite victim: panics, remains calm, delays trip to hospital, etc.
  

• Monovalent - Effective against one venom.
• Polyvalent - Effective against two or more venoms.

Species identified by an asterisk (*) indicate venoms used in the actual production of the antivenom.

The production of antivenom involves hyperimmunizing ungulates (sheep or horses) by injecting them over time with increasing quantities of snake venom. Blood is then drawn and fractionated to refine and concentrate the serum globulins. Add a couple of preservatives, such as Phenol and thimerosal, some distiled water, and you have an antivenom. The antibodies produced by the ungulates to combat the toxins in the venom now become the active ingredients in the antivenom.

Antivenom should only be administered by trained professionals for very severe snake bites. Some people have a severe allergy to antivenom (especially those derived from horses) and a skin test is usually standard procedure. Without using caution, the antivenom itself could potentially send someone into life-threatening anaphylaxis! Depending upon the severity of the bite, treatment may require 4 to 18 vials or more. Most antivenoms have no maximum dosage; only it is advised to use the minimum dosage necessary to counteract the effects of the venom.

The cost of antivenom will vary according to the market, but given that it is expensive to produce and generally in low demand, the price PER VIAL is likely to be $500-1000! (Remember that several vials are typically required to treat a bite.)
Due to the cost, relatively short shelf life, and concerns over allergic reactions, few snake researchers or hobbyists maintain their own antivenom stockpiles. For native species, antivenom is usually available quite readily, but the same cannot be said of exotic species. As part of their snake bite emergency plan, those keeping exotics usually research the location of the nearest available antivenom. Antivenom banks have become popular as a way for keepers to divvy up the costs of maintaining antivenoms for exotic species.

Note: Click here for The Miami-Dade Fire Rescue Antivenin Bank information and antivenom list.

• Wash the bite area with soap and water
• Remove any souvenir's (teeth) left behind with tweezers
• apply antibiotic ointment
• apply bandage if needed

How to Help Avoid Snake Bite

• Regularly trim hedges, keep your lawn mowed and remove brush from your yard and any nearby vacant lots. This will reduce the number of places where snakes like to live.
• Don't allow children to play in vacant, weed-infested lots.
• Always use tongs when moving firewood, brush or lumber. This will safely expose any snakes that may be hidden underneath.
• When moving through areas with tall grass and weeds, always poke at the ground ahead of you with a long stick or pole to scare any snakes away.
• Wear loose, long pants and tall boots when working or walking in areas where snakes are likely to be.
• Do not lift up rocks or wood with hands or feet.
• Never handle snakes, even dead ones. If you see a snake, slowly back away from it. Most people are bitten trying to get to close.
• Be aware of snakes if you are swimming or wading in rivers, lakes or other water such as flooding.
• Learn to identify poisonous snakes and avoid them.
• Use a good flashlite at night, this includes hiking trails, campsites, and even your front yard! Many snakes become more active at night, especially around dusk and dawn during the warmest parts of summer
• Always sleep on a cot when camping in snake-infested areas.
• In the summer months during times of drought, use extreme caution when in and around areas of water, regardless if it is a trickle of water from the pump of your swimming pool or a large lake. Also pay attention to your outside air conditioning unit during hot summer months. It is usually elevated off the ground , it is shaded and cool, and has an occasional trickle of water under their, making it the perfect place to hang out during the heat of the day.Most everything living thing needs water to survive, including snakes.

*Informational Note: There is an ongoing debate on whether or not the Timber Rattlesnake and the Canebrake Rattlesnake are of the same species. For the sake of this table, they will be listed as seperate species.

Snakebite Statistics

Landmasses	Population (x106)	Total number of bites	No. of envenomations	No. of fatalities
Europe	730	25,000	8,000	30
Middle East	160	20,000	15,000	100
USA and Canada	310	45,000	6,500	15
Central and South America	40	300,000	150,000	5,000
Africa	760	1,000,000	500,000	20,000
Asia	3,500	4,000,000	2,000,000	100,000
Oceania	20	10,000	3,000	200
Total	5,840	5,400,000	2,682,500	125,345

• Of the 45,000 snakebites reported annually in the United States, 7,000 to 8,000 are are caused by venomous snakes.
• 15 fatalities result, placing the chance of survival at roughly 499 out of 500.
• About 3,000 are classed as "illegitimate," meaning these bites occurred while the victim handled or molested the snake.
• 85 percent of natural bites are below the knee.
• 50 percent are dry. Strikes against humans are generally defensive actions. It is estimated that no venom is purposely injected about half the time.
• Incidence of snakebite is higher in males than in females (Most likely due to alcohol and testostorone) Young adults that are in the 18-28 age group are bitten most commonly.
• The majority of bites in the United States occur in the southwestern part of the country, in part because rattlesnake populations in the eastern states are much lower.[4]
• The state of North Carolina has the highest frequency of reported snakebites, averaging approximately 19 bites per 100,000 persons. The national average is roughly 4 bites per 100,000 persons.[5]
  
  

In the US, Coral Snakes are responsible for less than 1% of venomous snake bites in the US. Most people bitten by coral snakes are handling them intentionally. Probably less than 20 bites occur per year (though 61 alleged bites were reported to the American Association of Poison Control Centers in 1998). No deaths related to Coral Snake bites have been reported in the US since Coral Snake antivenom became available. Before that time, the estimated case fatality rate was 10%.

Mortality/Morbidity: No deaths related to coral snake bites have been reported in the United States since coral snake antivenom became available. Before that time, the estimated case fatality rate was 10%, and the cause of death was respiratory or cardiovascular failure. Patients who survive the bite may require respiratory support for up to a week and may suffer persistent weakness for weeks to months.

Cottonmouth Statistics

In the US, Cottonmouth are responsible for about 10% of venomous snake bites. The American Association of Poison Control Centers (AAPCC) has reported no mortality from Cottonmouth envenomation since its first annual report in 1983.

Mortality/Morbidity: The American Association of Poison Control Centers (AAPCC) has reported only one death from moccasin envenomation since its first annual report in 1983. Prospective studies of morbidity from moccasin envenomation have not been conducted. However, in two retrospective studies of copperhead victims, patients missed a median of 2 or 6 weeks of work.

Rattlesnake Statistics

Rattlesnakes (includes all species) cause about 75% of all bites by identified venomous snakes in the US. Dry bites, in which there is no envenomation, occur in as many as 50% of strikes. An average of 5.5 deaths per year occur as a result of snake bite in the US, most of these after Rattlesnake bites.

Mortality/Morbidity: Fewer than half a dozen deaths occur per year as a result of snakebite in the United States; most are caused by rattlesnake bites. Estimates of deaths each year from snakebite range from 30,000-110,000 worldwide. Up to 5 times as many individuals experience permanent morbidity.

• US mortality with administration of antivenin is approximately 0.28%. Without antivenin being administered mortality is approximately 2.6%.

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