Snake Bite Treatment
The southwest does harbor quite a few poisonous critters, including rattlesnakes. While these are some of the most venomous creatures in the country, you'll find that they usually avoid humans. It's only by being careless that you risk injury.
First of all, don't handle snakes. I've read that in Tucson, Arizona at least one person each year is rushed to the hospital when he (the victim is usually male, young, and under the influence) is struck by a rattlesnake as he tries to kiss it - NOT SMART. Don't stick your hands or feet into or under anything where you can't see - bushes, brush, dark corners, etcetera. At night (critters preferred time for moving about) wear shoes and use a flashlight while you are up and moving about.
The only time I have ever seen a rattlesnake was while hiking in Yosemite National Park. Although you will rarely come across a rattler, care must be taken to avoid a strike. In most cases, you will hear the rattle long before you can see the snake. If you hear the buzz of a rattler, freeze immediately and (without moving your head if possible) locate the snake with your gaze. Once the snake relaxes from a striking position, slowly move away. If you are within about three feet of the snake, you are in immediate danger of a strike. Double that distance, and you should be well out of its striking range.
When suffering from a snakebite, quickly move away from the snake and stay calm. The area of the bite may swell dramatically, so remove any tight clothing or jewelry. While nearly a third of snake bites are nonvenomous, "dry" bites, you should keep the victim calm, immobilize and splint the wound, and evacuate immediately (carrying the victim if possible). Please note: The use of a Sawyer Extractor is no longer recommended for snake bites. Do not apply cold, do not give alcohol to the victim, and don't use a tourniquet.
Hike Smart & Have Fun!
Brian
Brian, why is the Sawyer Extractor no longer recommended?
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Hi Ron...Thanks for the question. I've pasted below the email from Dr. Wagner of Tucson commenting on the use of Sawyer Extractors. Also, NOLS/WMI has stopped teaching the use of the extractor in the Wilderness First Aid Courses. You may notice that Dr. Wagner says he'd would use a tourniquet in some instances. I wouldn't recommend it for most people because I think they should only be used by people trained in their use.
Regards,
Brian
Dr. Wagner...
Thank you for your response to the article at EVliving.com. Yes, I do acknowledge that the subject of using a Sawyer Extractor has turned into a medical controversy.
Brian Lane
Brian,
I don't think there's any controversy anymore. There certainly wasn't at the Venom Week international meeting last year. In fact, there was widespread agreement that the device should no longer be used, not so much because of the risk of tissue damage, but because it might delay people from going to seek medical care and give them the impression that it will actually remove a significant amount of venom. If only a "small amount" of venom is removed after even "hours" of use, then at best the device is no better than a placebo. I can tell you from experience that removing a small amount of venom will have essentially no effect on clinical course or outcome. Often the biggest predictor of outcome is the time to definitive treatment (i.e., antivenom). That's what makes clinical studies of envenomations so difficult.
I treat a lot of snakebites every year, as does my friend Sean Bush, the guy on Venom ER. We have both seen several cases where bite victims developed rapid-onset systemic symptoms, including airway swelling that proved difficult to manage, and in one case resulted in a cric. In these cases, even several minutes can make a difference
in survival. Most of the advice that you gave in your article was excellent. I'd only ask that you recommend that people not bother with the Extractor and head for medical help ASAP. And I'd check with Dr. Auerbach again - I'm almost certain he no longer recommends the use of the Extractor.
What is still controversial is the use of pressure dressings or tourniquets if you are far away from medical help. Me? I'd rather lose an arm or leg than drop dead hours or days away from help. But I hope I never have to make that call...
Best,
Dr. Rich Wagner
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