With Texas leading the nation in the number of snakebites, we families must be prepared and have a plan in place in case your child is bitten.
Dr. Spencer Greene, consulting medical toxicologist at Texas Children’s Hospital and the only board-certified medical toxicologist in Houston
The biggest deterrent to being bitten is avoidance. Never reach into a hole or a bush blindly, as a snake may be resting there. 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 away when provoked.
Have a plan in place:
The most important thing a family can do is to have a plan in place prior to any emergency. This will keep family members from panicking and will most likely result in quicker treatment, as the family will be able to jump right into action. Some important things for families to do ahead of time include:
- Know which hospitals are closest to you and the route you will take to get there in case of an emergency.
- Make sure to have a list of those hospitals that carry antivenom.
- Never be scared to ask for a second opinion from someone who is familiar with the current snakebite management literature.
What to do if bitten:
One of the biggest misconceptions when it comes to snakebites is that the person bitten must have provoked the snake. This is not always the case. Regardless of the precautionary steps you take, sometimes bites just happen. If you or a loved one is bitten, some of the steps I recommend include:
- 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 swelling, which is the most common finding following pit viper bites.
- Go to the emergency center—the sooner the better.
The management of snakebites has changed over the years; the currently available antivenom has been shown to be safe and effective in minimizing pain, bleeding complications, swelling and tissue damage. Although antivenom is most effective in the first six hours after a bite, it has been found to be beneficial even a few days after the bite. At the hospital, physicians will determine if antivenom and hospital admission are necessary. When administered correctly, antivenom can eliminate the need for almost all surgical intervention.
If you’re uncomfortable with the proposed treatment plan, always seek a second opinion, ideally from a medical toxicologist trained in the management of envenomations.
Facts about treating snakebites:
- It is not necessary to bring the snake—dead or alive—to the hospital with you. In fact, it is highly recommended you not bring it.
- 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 been 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.
Regardless of the species of snake, all bites should be taken seriously. Even though most people who are bitten by venomous snakes have good outcomes, there is the potential for serious tissue damage and, on rare occasion, even death, from every species of copperhead, cottonmouth and rattlesnake in the U.S.