Getting bitten by a snake is shocking enough – don’t make it any worse.
As we teach more and more First Aid classes at CPR Seattle, our instructors get to hear about many misconceptions related to the emergencies we discuss in class. Even with the extensive information available online, some of these misconceptions are often cited and repeated by various sources. We try to clear up these errors whenever possible.
One section of the American Heart Association First Aid course deals with what we term “Environmental Emergencies”. These include treating exposure to heat and cold, addressing insect bites and stings, and injuries from other types of animals, including snakes.
There are a few treatments for snakebite that are occasionally brought up in class that are definitively not recommended for effective treatment. Usually preceded by the words “I heard somewhere that…”, these treatments are ineffectual at best, and at the worst, seriously hazardous. These include:
- Electric shock
- Tourniquets
- Cutting the bite and using suction
- Cauterizing the wound
- Applying alcohol
We'll llok at these in detail, and then go over the right ways to address this type of emergency.
Electric Shock
The use of electrical shock to treat a snakebite victim is a practice that even today persists in various places, especially in some online “resources”. The theory appears to be that by applying a powerful shock to the victim, that it somehow affects the venom in such a way that it becomes no longer harmful. Various delivery methods mentioned include car batteries, modified electrical equipment, and even Tasers.
Where did this theory originate, and why does it seem to persist? To answer the first question, the practice of treating snakebite with electricity seems to have been in use at the turn of the century1, but had a resurgence in interest after a letter (not peer-reviewed article) was published in 1986 in the Lancet journal by a doctor who claimed to be successfully treating venomous snakebites with electric shock therapy. Picked up by Time magazine, the New York Times, and most notably Outdoor Life, the treatment became more widely noted. Apparently the doctor was basing his theory off of anecdotal information from an Illinois farmer, who made the local paper by claiming that his severe reaction to bee stings was alleviated by the application of a “high voltage, low amperage, direct current shock to the site of his bee stings prevented his usual severe reactions”, however, the doctor did not cite when and where the article was published. For more on this story, see “Does electric shock treatment work for snake bites? Actually, funny story...” and A Review of Electric Shock Treatment for Snakebites (Just Say NO...)
Tourniquets
Tourniquets for snakebite are also not recommended, although their use may stem from misinterpreting the common practice of employing compression to the bitten limb via a bandage. As illustrated very well by the Queensland Health website (they definitely know their venomous snakes – Australia has roughly 13 gazillion venomous species), compression and immobilization will “retard the movement of venom from the bite site into the circulation, thus ‘buying time’ for the patient to reach medical care.” The effect of applying a tourniquet will be to concentrate the venom in one area, increasing tissue damage and necrosis (tissue death). In addition, swelling of the area may decrease circulation, making it harder for antivenin to get to the affected area. The idea is to slow the spread of venom by slowing lymphatic flow, but not to stop it entirely. For more on tourniquet use, see our previous blog post – “Tourniquets: Should you use one in an emergency?”
Cutting and suction
Just….just don’t. Cutting increases the risk of infection, and applying suction to remove venom does no such thing. Analysis of extracted blood indicates little to no venom can be removed in this manner (see Suction for venomous snakebite: a study of "mock venom" extraction in a human model), and mechanical extraction devices can actually damage the tissues around the injury, which can trap venom. Even worse would be to try and remove the venom by mouth.
Cauterizing the wound
Really? Welcome back to the 19th century. Cauterization, when cited by ancient sources, usually followed the aforementioned cutting-and-suction method. Apparently it was felt that once the venom was removed via severe bleeding (which we know didn’t work) then burning the tissue would destroying any remaining toxin (which we know REALLY didn’t work). At this point, the victim may as well just shoot their finger off, right?
Whoops.
Applying alcohol
Ok, so this might not be a problem – one recommendation is to wash the bite with soap and water to disinfect it; applying alcohol topically might achieve the same purpose. One thing that should definitely not be done with alcohol is to have the victim drink it – and that goes for caffeinated drinks as well. These could speed the victim’s body absorbing the venom by increasing the circulation rate.
An interesting side note is that the November 1918 issue of Outdoor Life printed a letter from a reader who wrote that “The simple remedy of fire application is more effective than all the ammonia or whisky that ever came from a drug store or saloon”2. Good to see that the readers always kept up with the latest science.
What’s the right thing to do?
Now that we’ve seen what not to do, let’s review the current American Heart Association First Aid recommendations for treating snakebite:
- Make sure the scene is safe.
- Ask another adult to move any other people inside or away from the area and phone your emergency response number (or 911).
- Ask the bitten person to be still and calm. Tell him to avoid moving the part of the body that was bitten.
- Remove any tight clothing and jewelry.
- Gently wash the bite area with running water (and soap if available).
Important: Scene Safety and Snakes
- When making sure the scene is safe, be very careful around a wounded snake.
- Back away and go around the snake.
- If a snake has been killed or hurt by accident, leave it alone. A snake might bite even when severely hurt or close to death.
- If the snake needs to be moved, use a long-handled shovel. If you don’t need to move it, leave it alone.
Prevention is key
The odds of dying from a snakebite in the United States are very low. Out of approximately 45,000 snakebites per year, only 5 or 6 deaths occur. Many of the snake bites are caused by intentionally handling the snake. Statistics show that most victims are male, between 20 and 40, and that the bite occurs after reckless behavior attributed to the consumption of alcohol. In other words, it’s not the snake’s fault.
Also, if you plan on spending time outdoors in unfamiliar areas, especially those without close medical aid, we recommend familiarizing yourself with the local species to find out which may be venomous, and how to prevent contact. A little knowledge can go a long way.
1Venomous Snakebite: Past, Present, And Future Treatment Options Kames R. Blackman, M.D. and Susie Dillon, M.D. - Journal of the American Board of Family Medicine
2 (1918, November). In the Game Field. Outdoor Life, Volume 42 p 329.
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Published on December 9, 2015
- Category: Emergency
- Posted On: Apr 21, 2022
- Written By: Baton Rouge General
Warmer weather means you may be spending more time outdoors hiking, fishing, camping or just working outside. While Louisiana has a lot of outdoor activities to offer, we are also home to nearly fifty species of snakes, seven of them venomous.
Fortunately, snake bites are relatively rare. Only one in 37,000 people are bitten by snakes each year, and one in 50 million die from the bite. Snakes aren’t typically aggressive and generally won’t bother you unless they feel threatened. In fact, most snake bites happen because people don’t realize a snake is there before placing a hand or stepping somewhere. Sometimes people may not even realize they’ve been bitten, especially if it happens in the water. But, if you think you’ve been bitten by a snake, what should you do?
First, what not to do:
- Don’t assume the snake was harmless or wait to see if symptoms will get worse. Always treat a snake bite like it’s venomous and get help right away. Even a bite from a non-venomous snake can be serious, causing an allergic reaction or infection.
- Don’t try to kill the snake. Many secondary bites happen when someone tries to kill the snake. If you can get a picture of the snake safely, that may help your care team. But, contrary to popular belief, it’s not required that you identify the snake to get treatment. Emergency rooms know how to use your physical symptoms and bite marks to determine if anti-venom is required.
- Don’t suck out the venom, and don’t use a snakebite kit.
- Don’t apply a tourniquet. Years ago, some scouts were taught to use a tourniquet for snake bites, but now we know that they can create complications and increase the risk of blood clots and amputation.
- Don’t take aspirin or ibuprofen. Some snake venoms already thin the blood, and pain relievers can increase that effect.
What to do:
- Try to stay calm. Even if you’re bitten by Louisiana’s most dangerous snake, the Eastern Diamond Rattlesnake, you have time to get to an emergency room before serious complications occur.
- Call 9-1-1 or head to the nearest emergency room, as soon as possible. They’re stocked with anti-venom and will start treatment immediately.
- Remove rings and watches before you start to swell.
- If you have a pen or marker, circle the site of the bite and write the time that it occurred so your care team can monitor how fast you’re swelling.
- If you have time and access to clean water, clean the bite and cover it with a clean dressing while you are being transported to the hospital.
- Keep your bite below your heart if you can.
As with everything, it’s easier to prevent a snakebite than to treat one. Always take the following precautions when outdoors:
- When hiking, stick to trails. Avoid tall grass and heavy underbrush where snakes like to hide.
- Wear appropriate shoes when you’re outside – never go barefoot or wear sandals or flip-flops when walking through the wilderness.
- Watch your step, and don’t put your foot in a hole or crevice.
- Never put your hands in spots where you can’t see.
- Examine logs or rocks before sitting down.
- If you see a fallen tree or a large rock in your path, make sure you can see the other side before you step.
- Don’t grab sticks in the water. Sometimes they aren’t sticks!