wilderness snakebite survival

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wilderness snakebite survival

Post by Koda » April 4th, 2012, 4:16 pm

Now here is something I know nothing about (other than Google) so perhaps a forum discussion can yeild some answers. I have a snake bite kit.... the kind that has some suction thingy where you suck the venom out. Seems these kits are readily available but yet I keep hearing never to suck the venom out as this is actually ineffective.

here is a good reference article... http://www.wildbackpacker.com/wildernes ... nake-bite/ Great article, but really doesn't cover what to do if you can't get help.

So my question what to do is based on two wilderness scenarios...
1) where you are waiting for the SAR team to arrive
2) where there is no possible communication to 911 or other....

and of course...
3) prevention techniques

I'm obviously concerned about scenario #2, it would be great if we could focus on that. Last but not least, we could talk about all poisonous snakes but lets focus primarily on Rattlers since that is what we have in Oregon. (if we have more, do tell.... )


*edit minor spelling error.... doh!
Last edited by Koda on April 5th, 2012, 7:48 am, edited 1 time in total.
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Re: wilderness snakebite suvival

Post by Grannyhiker » April 4th, 2012, 6:06 pm

Koda, that's a really good article you came up with!

There is a horrendous amount of information, much of it inaccurate, about snake bite. The treatment protocols have changed considerably, so any information more than 7-8 years old or, worse yet, undated, should be ignored. Also, even though snake bite kits are still sold, don't buy one and throw them away if you have them!

From the text used for the Wilderness First Aid course I took two years ago: Backer, Howard D., M.D., et al, Wilderness Medical Society, Wilderness First Aid: Emergency Care for Remote Locations, 3rd edition. Sudbury, MA, Jones and Bartlett Publishers, 2008. pp. 278-283
What to Do...
1. Get the victim away from the snake....Do not attempt to capture or kill the snake....
2, Do not attempt oral suction or incising the skin. Suction is not effective.
3, If there are immediate, severe symptoms, keep the victim quiet. Activity increases venom absorption. Send for help immediately.
4. Start to evacuate all victims at once. To be effective, antivenin is best given within 4 to 6 hours after the bite.... Keep the limb below the heart and clean the bite.
5. Use a sling or a splint to loosely immobilize the affected limb.
6. If there is no immediate reaction, start to walk slowly with the victim to the trailhead. Sending for help can take longer than walking for help. If evacuation is prolonged, and there are no symptoms after 6 to 8 hours, there probably has been no envenomation.

...Bites without signs of venom injection require only a tetanus shot and care of the bite wounds.

Use cold or ice...
Use the cut-and-suck method...
Use mouth suction...
Use a tourniquet...
Use alcohol...
Use aspirin...
Use any suction device...
This information was confirmed not only by our WFA instructors but also by my-son-in-law-the-ER-physician who did his residency in southern California, where he had quite a few rattlesnake bites come into the ER. Rattlesnake venom works by breaking down the walls of the blood vessels, and anything that damages or constricts the tissue or affects circulation (blood thinners like aspirin or NSAIDs) in any way just makes the damage even worse, often leading to gangrene.

The above protocol is for pit viper (rattlesnake, copperhead, water moccasin) bites. For coral snakes, which have a different type of poison, the first aid protocol is somewhat different, involving the use of an elastic bandage. Of course the only venomous snake we have in Oregon is the rattlesnake, found primarily east of the Cascades.

The best treatment is prevention--make noise as you hike, watch where you are putting your feet and hands, at night carry a flashlight and use it. Oregon's rattlers are not the aggressive variety found in the southwest. I would keep my dog on leash and behind me in snake country.

My response to snake bite (and other serious emergencies) would also involve pushing the button on my personal locator beacon (or the 911 button on a SPOT). I would wait a few minutes, though, to be sure the bite was envenomated (about 25% of rattlesnake bites are "dry"). The obvious symptoms of envenomation are severe burning pain at the bite site and swelling starting within 5 minutes.

For what it's worth, it was stated in my WFA class that nearly all snakebite fatalities in this country involve young males, alcohol and phrases similar to "Watch this!"
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Re: wilderness snakebite suvival

Post by Lurch » April 4th, 2012, 6:40 pm

Nice written Granny! I don't have any first hand experience with bites... but I'll weigh in...

There's a reason the vast majority of snake bites are on the hands and forearms. (People trying to catch / kill the snake).

The suction things are useless for the most part. There was a study done a few years ago with synthetic venom "snakebites" in pigs. The extraction from those "suckers" was minimal at best, and some of doctors in the experiment actually said that they could cause damage to the surround tissue beyond what the venom itself would do.

Other than that, STAY CALM, I know that's going to mostly be impossible, but the more excited you get the faster venom will spread. Keep movement to a minimum, and if possible keep the bite below the heart.

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Re: wilderness snakebite suvival

Post by jessbee » April 4th, 2012, 7:28 pm

Grannyhiker's response is excellent, and there's not much more to be said.

Prevention is really it, don't try and pick up a rattler. These animals are pretty shy and would rather get away from you than bite you.

Keeping calm, immobilizing the limb and staying put (if possible) or leaving the area to get help slowly is what I learned from my WFR course a few years ago. As your heart rate increases, the venom circulates through the blood more quickly. Snakebite suction kits are toys.
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Re: wilderness snakebite suvival

Post by Koda » April 5th, 2012, 7:46 am

In short, if you cant call or get help your screwed to an untimely death? What can you do to prolong your death (in hopes of being found) and is there any hope of riding out the storm? How long does the venom last? How bad does the venom affect you... can you stagger out on your own, albeit slowly? What are any risks associated with any self rescue?

I want to know what to do here when you can't get help.

In all other cases very excellent advice here, especially the list of "don'ts". I guess if traveling far into snake country a spot or PLB is the best first aid "snake kit" to carry, perhaps the only....
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Re: wilderness snakebite survival

Post by potato » April 5th, 2012, 8:33 am

Check out this thread, especially chameleon's story... http://www.portlandhikers.org/forum/vie ... f=7&t=4990
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Re: wilderness snakebite survival

Post by Koda » April 5th, 2012, 10:07 am

Excellent, thanks for finding and sharing that one Radpotato. Eye carumba, that is an amazing story as well as the first I have read about what to do when you can't call for help. To summarize that here...

When self extraction is the only choice...
  • calm down if possible and get away from the snake
  • clean or sanitize the wound
  • remove any constricting clothing, jewelry or items
  • cache your heavy gear, and take only the minimum for a UL marathon to hike out
  • hike out the easiest way. This might not be the shortest route. Go easy, do everything to avoid exerting yourself, but keep moving.
As importantly, there are the "don'ts"...

  • attempt to extract venom. This includes the Sawyer Extractor or any pump or mouth suction or any suction.
  • take ibuprofen or aspirin
  • apply ice or cold [water] treatment
  • use Alchohol (whiskey for the pain?)
Lets critique this list as needed.
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Re: wilderness snakebite survival

Post by Koda » April 5th, 2012, 10:26 am

...and then what to do when help is available I would think there are a few different scenarios. Along with following the prementioned "don'ts"
  • get away from the snake
  • calm the victim, keep them warm
  • clean the wound
  • call 911 or activate the PLB or SPOT service
Stands to reason if your a ways in (distance) then carrying the victim closer to the trailhead might really help any SAR team efforts, as long as its safe and effective to do so. If your in a situation where there is no cell service and without a PLB/SPOT device then I would think it appropriate to send someone for help... prep the victim for an overnighter and send your fastest trail runner for help.

The bottom line after reading Zach's story that albeit rare, is this is serious enough to warrant documenting what to do in all situations. I imagine that in Zach's story if any one of those rafters knew anything about snakebites they would have went for help.... and should have.
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Re: wilderness snakebite survival

Post by sloth » April 5th, 2012, 12:52 pm

Hey, I love the thread (just signed up so I could comment. Thanks for everything on the site) I notice that most of the recommendations are different from those in the Field Guide->About Hiking->Snakes page. Not sure if there is anyone to update/maintain that, but wanted to mention it...

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Re: wilderness snakebite survival

Post by jdemott » April 5th, 2012, 1:17 pm

There seems to be some difference of opinion on whether to use a commercial snake bite suction device like a Sawyer. The Wild Backpacker article cited above advises against using one, but that article cites the National Institutes of Health http://www.nlm.nih.gov/medlineplus/ency ... 000031.htm which actually recommends the use of the Sawyer, as does the University of Maryland article also cited by Wild Backpacker. My guess (and it is only a guess) is that a Sawyer type device could have some marginal benefit if used immediately after a bite, but it would be less beneficial if there was even a minute or two delay, which would probably be a typical response time to retrieve the first aid kit after a snake bite. It may be that some of the experts recommend against using any suction device in part because they don't want to inadvertently encourage anyone to try the old cut and suck approach as a substitute, which would have some obvious risks. Does anyone have any info about actual data on which these recommendations are made?

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