Summertime Can Mean Snakebite

Sue Hubbard, M.D.

Due to wet weather and heat, news reports have families on alert: Snakes are being pushed out into the open. More snakes means the potential for snakebite. I'd never treated a patient with a snakebite and thought they were quite uncommon - until a rattlesnake bit a friend of mine (now recovered). Upon review, I've learned a lot about venomous snakes.

More than 45,000 snakebites are reported in the U.S. each year. The majority are inflicted by non-poisonous snakes and often require little or no treatment. The days of applying crude tourniquets to the area of the bite, then making a cut and "sucking" out the venom are over. Don't start practicing "movie medicine" if you find yourself dealing with snakebite.

About 8,000 venomous snakebites are reported each year. Fortunately, with the advent of anti-venom, only six to eight people die each year from such bites. Unfortunately, due to their smaller size, children don't handle snakebites as well as adults, and the fatality rate is higher in children. In the United States, 99 percent of poisonous snakebites are inflicted by the subfamily pit viper, which includes rattlesnakes, copperheads and cottonmouths. The other species of poisonous snake found in the U.S. is the coral snake.

I won't detail the specific treatment for each type of bite, but if a snake bites your child, the first thing to do is determine if it was a poisonous snake. Non-poisonous snakebites cause minimal pain, no swelling, and really require only local wound care with irrigation and antibacterial soap.

If the bite is thought to be from a poisonous snake, however, the child should be transported to the nearest hospital. Do NOT put a tourniquet at the site, apply ice, or suction the area of the bite, as these actions are all thought to cause more tissue damage than benefit. Pit viper bites typically cause swelling, bruising and progression within minutes of the bite. Children typically have more severe symptoms, including nausea, vomiting, sweating, muscle weakness and clotting abnormalities, all of which are medical emergencies.

Anti-venom should be delivered within four hours of the bite and will be given until improvement in systemic symptoms is achieved. All of this is done in an intensive care unit (ICU) setting.

Dr. Sue Hubbard is a nationally known pediatrician and co-host of "The Kid's Doctor" radio show.

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