Imagine this: You’re on a hike with your family and you stop for a break next to the trail. You take a bite into your sandwich only to feel a searing pain in your ankle.
You’ve just been bitten by a snake.
What do you do?
Do you cut and suck? Apply a tourniquet? Or run to the nearest hospital?
Unfortunately, there’s a lot of misinformation out there about what you should actually do if you’re bitten by a snake. All this misinformation has led people to do things that can make your situation worse if you ever end up in a precarious situation with a snake.
To ensure that you’re prepared to handle any eventuality when you’re outside, here are some best practices for dealing with snake bites in North America.
NOTE: This article provides general background information, only. Anyone performing any medical or first aid skills discussed in this article must take full responsibility for their actions. It’s highly recommended that anyone looking to do any of the skills discussed in this article take a first aid course from a qualified provider or seek out further first aid training.
What Are The Odds of Being Bit By A Snake?
According to the World Health Organization, approximately 5.4 million people get bitten by snakes each year. Out of all of these snake bites, about 1.8 to 2.7 million people end up getting envenomated (i.e., poisoned by a snake), which results in about 81,000 to 137,000 deaths per year.
However, if you look at this in terms of the entire Earth’s population, about 0.0008% of people get bitten by a snake each year. That being said, the majority of these snake bites happen in Asia, Africa, and South America – places that happen to have the majority of the world’s venomous snakes.
According to the CDC, approximately 7,000-8,000 people in the US get bitten by a venomous snake each year, and only 5 of them die.
If we do the math, we’re looking at a less than 0.00002% chance of getting bitten by a snake in the US each year and a less than 0.00000005% chance of dying from a snake bite.
Some people see these numbers and think: Hey, I don’t have to worry about a snake bite – people rarely die from them in the US. While that’s certainly true, the CDC also notes that up to 44% of people who get bitten by a snake experience a permanent injury as a result.
So, if you plan on spending anytime outdoors or, if you live somewhere with a decent population of venomous snakes, knowing what to do and what not to do is of the utmost importance should things go awry.
Types Of Venomous Snakes In North America
Since there are quite literally thousands of species of snakes in the world, I can’t possibly talk about all of them in one article. Thankfully, we here in North America have very few venomous snakes, so learning how to deal with snake bites in this part of the world isn’t as complex as it is elsewhere.
With that in mind, any discussion of snake bite first aid needs to start with a look at the types of snakes that you could possibly be bitten by as this has an impact on the treatment plan you’ll need to follow in an emergency.
In North America, our primary concerns are rattlesnakes, copperheads, cottonmouths (a.k.a. water moccasins), and coral snakes.
Rattlesnakes, copperheads, and cottonmouths are what we call “pit vipers” (or crotalids). These snakes have venom that includes a hemotoxin (blood toxin) that destroys blood cells, stops clotting, and damages tissues.
On the other hand, coral snakes are elapids, which means that their venom secretes a neurotoxin that can paralyze our respiratory system and cause asphyxiation.
Identifying Venomous Snakes In North America
Thankfully, we only have 4 types of venomous snakes in North America. This makes identifying snakes that could be dangerous a bit simpler than somewhere like Australia, which has some 100 species of venomous snakes.
Here are some tips for identification of venomous snakes in North America:
While it’s easy to joke that a rattlesnake is simple to identify because it, well, has a rattle, if you’re at the point where a rattlesnake is rattling, then you’re likely too close for comfort.
There are over two dozen types of rattlesnakes in North America, though the eastern and western diamondback often get the most attention.
It’s generally somewhat simple to identify these rattlesnakes because they have triangular heads, diamond-shaped patterns, and a rattle. Some snakes, like the eastern indigo snake, which are not venomous, actually try to pretend to be rattlesnakes by hissing and vibrating their tails.
When in doubt, if it looks like a rattlesnake, back away. If a snake is rattling at you, that’s a good sign that you need to move away swiftly, but without making any sudden movements.
Copperheads are often confused with non-venomous snakes, such as northern water snakes. In general, copperheads have a more arrow-shaped head with slit-shaped eyes.
However, perhaps the most definitive way to identify copperheads from a relatively safe distance is to look at their pattern. Copperheads usually have a more wiggly-lined hour-glass shaped pattern while northern water snakes often have a bulb or stripe-like pattern on their scales.
These snakes are located mostly in the southeastern US, from Texas to the Atlantic coast and as far north as Missouri. Cottonmouths are usually quite long, with thick bodies and arrow-shaped heads.
They vary in color from tan and brown as young to a greenish/black as an adult. Most adult cottonmouths also have a white line above each eye as well as a very white mouth (hence the name). If a cottonmouth feels threatened, it will usually open its mouth to try to scare you off, which is a good sign that it’s time to hit the road.
The coral snake is notoriously difficult for people to identify, mostly because of its similarities to other snakes, like the milk snake. Both of these snakes have yellow, black, and red striped band patterns, though the order of these bands differs.
There’s a simple rhyme to help people identify venomous coral snakes and their friendly lookalikes, just by their pattern color:
- Red & Yellow: Kill a Fellow
- Red & Black: Venom Lack
So, if the snake has a pattern where the red and black bands are next to each other, then you’re a-okay. Otherwise, it’s best to back away slowly.
Snake Bites Dos & Don’ts
Now that you know the difference between the two main types of snakes that we have in North America, we can talk a bit about how to deal with their bites. Here are some dos and don’ts for snake bites in North America:
Avoid Getting Bitten By Snakes
Many people who get bitten by snakes get bitten on the hands and arms. Since snakes generally exist at ground level, this information should tell you that not all snake bites happen “out of the blue” – in fact, many snake bites happen because people are handling snakes when they probably shouldn’t be.
Indeed, North American snakes are not generally aggressive and will try to get away from you, unless they feel provoked. Avoid disturbing snakes whenever possible, and certainly don’t pick them up unless you’re trained to do so.
Regardless of the type of snake that bit someone, a high heart rate will help the toxin spread faster, which is the last thing you want.
Clean & Disinfect The Wound
Snake bites, like all animal bites, are very prone to infection. While this isn’t an immediate life threat, setting yourself up for success now by cleaning the bite site with soap and water is a great idea.
While you’re doing this, don’t forget to remove any jewelry, including rings, bracelets, and anklets, from near the bite site as they can cut off blood flow.
Evacuate To A Hospital
In an ideal world, the person that got bit would get airlifted out to a top-notch hospital that’s chock full of the world’s leading experts on snake envenomations.
Is this likely to happen? Not at all, and helicopter evacuations, in my experience, take much longer than people think.
So, if the patient can walk slowly back to the car, that’s a good idea. Otherwise, they’ll likely need to be carried so that they don’t over-exert themselves en route to the hospital.
Immobilize The Extremity
Most people get bitten by snakes on the arm, hands, or legs. So, to help slow the spread of the venom throughout the body, try to immobilize the extremity – especially arms – with a makeshift sling. If the bite was on the leg, it’s best if the patient doesn’t walk out of the backcountry under their own power.
In addition to immobilizing the injured extremity, some schools of thought encourage people to wrap the extremity with a 6” wide elastic bandage. The general idea is that you’d wrap the injured extremity from distal to proximal and then back to distal.
What does this mean?
Well, if someone was bitten on the hand, you’d start wrapping at the wrist, go up to the shoulder, and then wrap back downward to the hand. The idea is that this pressure wrap can slow the spread of the venom. Here’s a good video to check out from TacMed Australia if you want to see how this work:
However, there’s a bit of controversy surrounding the use of this technique for pit vipers (rattlesnakes, copperheads, and cottonmouths), as there’s a fear that this can increase the risk of more localized damage of the tissue by concentrating the hemotoxin in one place.
So, if you’re interested in learning more about this technique and when you should/shouldn’t use it, it’s best to take a wilderness first aid course where you can learn all about how to do this properly.
SnakeBite911 is a free app that can be helpful for anyone that lives in or travels to areas in the United States with high concentrations of venomous snakes. The app was created by CroFab, the manufacturers of the main antivenom used for crotalid (pit viper) bites in North America.
With the app, you can learn how to identify different North American pit vipers, get tips on how to avoid snake bites, and you can even search for different snakes that live in your region.
The app also has a cool feature where it allows you to take time-stamped photos of a snake bite so you can track the spread of the venom before you get to the hospital. It will also help locate nearby hospitals that are capable of handling serious enevemations and will even help you call 911 or the poison control center in an emergency.
Traditionally, people used to use a wide range of tactics to deal with snake bites in the outdoors.
Pretty much all of these techniques fall into our list of “don’ts” for dealing with snake bites because they either don’t do anything or can make the situation worse. This includes:
- Cut and suck
- Applying cold packs
- Drinking alcohol or caffeine
- Taking aspirin or ibuprofen
- Wrapping the bite area too tightly
It also includes trying to pick up and kill the snake or trying to bring it into the hospital with you. Not only can this cause more snake bites, but I can assure you that the hospital does not want to deal with a snake bite and a live snake at the same time.
Since there are so few venomous snakes in North America, most hospitals will have staff that can determine the type of snake bite that they’re dealing with without having to see it in person.
Snake bites in North America are, thankfully, quite rare. However, they can cause serious injuries and, in rare situations, death, so knowing how to deal with them appropriately is essential.
If you want to learn more about how to handle medical emergencies, like snake bites, in the outdoors, I highly recommend taking a class, so you can practice these techniques before you have to use them for real.