{"id":78149,"date":"2024-09-14T07:41:48","date_gmt":"2024-09-14T13:41:48","guid":{"rendered":"https:\/\/thetacticalhermit.com\/?p=78149"},"modified":"2024-09-14T07:41:48","modified_gmt":"2024-09-14T13:41:48","slug":"practical-skill-sets-snakebite-management-pre-hospital","status":"publish","type":"post","link":"https:\/\/thetacticalhermit.com\/index.php\/2024\/09\/14\/practical-skill-sets-snakebite-management-pre-hospital\/","title":{"rendered":"Practical Skill-Set’s: Snakebite Management (pre-hospital)"},"content":{"rendered":"

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Snakebite Management (pre-hospital)<\/a><\/h1>\n

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Please allow me to introduce myself. I am a medical toxicologist and emergency physician at\u00a0Baylor College of Medicine in Houston, Texas<\/a>. I have treated 600+ snakebites and direct one of the busiest snakebite services in the U.S.<\/h2>\n

I also love snakes and consider myself a member of the herpetology community. And I want to help prevent any bad outcomes (for both humans and snakes) if a snake-human interaction goes awry.<\/h2>\n

I have seen A LOT of bad advice regarding snakebite management in this and other groups, and I\u2019d like to set the record straight.These are the recommendations for pre-hospital treatment. I will have a different post dealing with hospital management.<\/h2>\n

If you get bitten by a snake you suspect is (or may be) venomous:<\/h2>\n
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  1. \n

    Get away from the snake. No need to hurt the snake just because you\u2019re angry, and you don\u2019t want to incur additional injury.<\/h2>\n<\/li>\n
  2. \n

    If you (or someone else) can\u00a0safely<\/span>\u00a0and\u00a0quickly<\/span>\u00a0get a picture of the snake, great, but don\u2019t waste time or risk a second envenomation. Ultimately, pit viper (rattlesnakes, copperheads, cottonmouths\/water moccasins) envenomations are diagnosed clinically. As are coral snake bites, but most people can identify those. Just pray you have a doctor who knows what he or she is doing (see below)<\/h2>\n<\/li>\n
  3. \n

    Remove constrictive clothing and jewelry<\/h2>\n<\/li>\n
  4. \n

    Position the affected extremity appropriately. This is a little controversial, but some things are clear. For pit viper bites (which account for > 95% of the venomous snakebites in the U.S.), DO NOT PLACE BELOW HEART LEVEL. Almost all pit viper bites cause local tissue injury, and placing the affected extremity below heart level will cause the venom to collect in the extremity and will increase the hydrostatic pressures in the extremity. This will increase the potential damage to lymphatic vessels and increase the likelihood of some degree of permanent injury, such as post-exertional swelling. For copperhead and cottonmouth bites, in which local tissue is highly likely but the likelihood of systemic toxicity is low, I recommend placing the affected extremity ABOVE HEART LEVEL. In rattlesnake bites, it is reasonable to keep the affected extremity AT HEART LEVEL.These variations are for pre-hospital management. Once in the hospital, the affected extremity should always be elevated. This is emphasized in the\u00a0unified treatment algorithm<\/a>.<\/h2>\n<\/li>\n
  5. \n

    Get to an appropriate hospital. If you are having life-threatening signs and symptoms (e.g. airway issues, low blood pressure) get to the closest hospital for stabilization. They can then transfer you if needed to an expert. Otherwise, proceed directly to a hospital with a snakebite expert. If you interact with snakes a lot or are outside in snake-endemic areas, you should investigate your regional hospitals to locate one or more specialists. I can help you with this. It\u2019s a pretty small community.<\/h2>\n<\/li>\n
  6. \n

    Avoid dangerous and\/or stupid interventions:<\/h2>\n