The Snakes of Spring

A friendly python?

Everything you know about rattlesnakes and their bites is probably wrong.

They are not an aggressive reptile, unless you are a small warm-blooded mammal. They prefer to hide, and they retreat if you are bigger that a gopher. They will rattle their tails off trying to make you go away. They understand you are too big to swallow and only bite in self defense, when they think you are trying to kill them. Keep in mind that their brain is the size of a pea.

Rattlesnakes are near and dear to me, probably because I live in Phoenix, Arizona, the rattlesnake capital of the nation. Did you know we have 17 different species of rattlesnakes in Arizona – the most of any state? It kind of makes you rethink the Desert Retirement Plan, doesn’t it? My wife has called me saying, “Honey, there is a rattlesnake on the porch.” We see them not infrequently. They usually slither off.

Rattlesnake bites in Arizona are largely limited to the upper extremities, between the fingertips and the elbows. Not coincidentally, most “victims” (if you want to call them that) are young, often intoxicated males. They were playing with the snake, often with a short stick (imagine that).

When I talk about rattlesnakes, my best advice on what to do if you encounter one is: immediately put your hands in your pockets and don’t take them out.

So let’s say you didn’t listen, or were just plain unlucky, and the rattlesnake bites you. You are going to be in a lot of pain, but you are not going to die. Ninety-nine percent of bites don’t result in death.

About 20% of bites do not envenomate you, which is a so-called dry bite. This is a bite that is no more painful than a vaccination. You still need to get it checked out, pronto, but you will not need antivenom.

So what do you do when you get bit? Get away from the snake, so you don’t get bit again because the snake still has spare venom. Pick up your cell phone and call 911.

What don’t you do? Do not cut and suck! You cannot even hope to get the venom out. A home study experiment: Take blue dye in a syringe and inject it into an orange. Now try to get the dye out of the orange without destroying the orange. Try cutting and sucking. Doesn’t work, does it?

Besides not cutting and sucking, you never apply a tourniquet. Rattlesnake bites swell like crazy. They do a lot of local tissue damage. Cut off the blood supply with a tourniquet, and you will lose the limb. Keep in mind, as long as you can get medical attention within two hours, you have a 99% chance of survival.

Symptoms of a rattlesnake bite are pain, sometimes severe pain, at the bite. The area will swell markedly. Systemic (generalized) symptoms include nausea and vomiting, weakness and potential heart failure.

Antivenom is used if you have severe local symptoms, such as swelling so bad that the limb will rupture the skin. It is almost always used if you have generalized symptoms.

Antivenom is made up of neutralizing antibodies from a horse. The antivenom maker injects rattlesnake venom in a horse and then collects the antibodies the horse makes against the venom. Pretty neat. Remember that these are antibodies from a horse, so you are going to have some reaction. Rarely this reaction can get exciting (that’s the 1%).

You almost always have the opportunity to avoid a bite. The snake will warn you with a dry-sounding rattle. It sounds like you put dry rice in a paper bag and shook it. There is nothing else that commonly rattles, so assume it’s a snake. Stop and listen to decide which direction the snake is, then go the opposite direction immediately. That will almost always keep you from being bitten.

Take care,

Dr. B


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