Rattlesnakes on Our Barrier Islands; Part 3 – Envenomation

Though encounters with Eastern Diamondback Rattlesnakes are rare, bites from them are even more rare, and deaths from those bites almost nonexistent, it is worth discussing the issues and remedies of a bite.

About 8000 people are bitten by snakes each year in the U.S. and Canada.  Most are on the hands of men who were engaging the snake.  95% of those bitten are trying to either catch or kill them.  Annually less than 12 people die from some species of rattlesnake bite.  Many are young or old, with a suppressed immune system or pre-existing medical condition.  Many who die, for whatever reason, refused medical treatment.

Most lethal bites are those that reach the heart or brain.  However most bites are on the extremities where tissue and nerve damage can occur, but death is less likely.  One reason some may refuse medical treatment is cost.  Antivenin treatments are expensive.  Typical bites may require 4-6 vials and costs were between $1500-$3500/vial in 2010.  Add to this the cost of hospital stays, and you can see how expensive it can be.

Another reason given as to why medical attention was not sought is the fact that many venomous snakes will give what is called a “dry bite”.  As mentioned in earlier articles, snake venom is “expensive” for snakes to produce, and it is intended for prey – not predators.  Rattlesnakes will often give what is called a “bluff bite” – striking with their head but not even opening their mouths.  The injection of venom is a voluntary action by the snake, and they may choose to inject very little, if any, venom even if the fangs penetrate.  It is believed that about 50% of the rattlesnakes are dry bites.  That said, you should never gamble on whether you received venom or not, you should go to the hospital.

The venom itself is a cocktail of proteins, polypeptides, digestive enzymes, and other compounds.  It is basically modified salvia – which already includes some digestive enzymes.  Myotoxins are a large component of rattlesnake venom.  Myotoxins attack muscle tissue, cause pain, discoloration, minor bleeding, and swelling.  This can be accompanied by chills, sweats, dizziness, disorientation, tingling and numbness of mouth and tongue, metallic taste, vomiting, diarrhea, bloody stools, alternating blood pressure and heart rates, blurred vision, muscle spasms, and neurotoxins can paralyze diaphragm leading to asphyxiation.

To avoid envenomation problems wear closed-toed shoes when hiking in rattlesnake territory.  Do not extend your hand into brushy/grassy areas – use your hiking stick instead. Watch stepping over, or sitting on, logs and stumps without close surveying.  Do not touch dead rattlesnakes, if not dead long, they can still bite.  Carry a cell phone.

 

What to do if bitten…

Call 911.

Call poison control if you have their number.

Get to a hospital.

Remove rings, watches, etc. – swelling will occur.

Keep bite at, or below, heart level.

Remain calm.

What NOT to do if bitten…

Do not cut the wound.

Do not suck venom out.

Do not apply a tourniquet.

Do not apply ice.

Do not drink alcohol.

Do not use electroshock treatment.

Envenomation from an eastern diamondback rattlesnake is a scary thing.  However, there are many ways to avoid this problem, and there is basic treatment if you are.  Remember few people are bitten, and very few die.  Get medical attention as soon as you can.

References

 

Rubio, M. 2010. Rattlesnakes of the United States and Canada. ECO Herpetological Publishing & Distribution. Rodeo, New Mexico. pp. 307.

Gibbons, W., Dorcas, M. 2005. Snakes of the Southeast. The University of Georgia Press. Athens, Georgia. pp. 253.

Graham, S.P. 2018. American Snakes. John’s Hopkins University Press. Baltimore, Maryland. pp. 293.