[at-l] Snakebite Treatment

[agaudet at theworld.com (Arthur Gaudet)]

Both Little Bear and OrangeBug have given worthwhile advice for typical 
hiking along the AT but have misinterpreted the message/question in my 
3-part email. That's probably because I didn't outline the message well 
enough, likely because I've been thinking about this scenario off & on for 
a long time, since the incident at Blackrock Hut, July 29, 2000. This is in 
the Shenandoah.

I have no qualms about getting myself to an ER when that is possible 
without endangering my life in the process. Of course many places along the 
trail offer egress to a road where I can flag down a car and get help. That 
is not the scenario that I described, experienced.

If either of you are doctors and wish to give medical advice: I'm looking 
for the relative risk of death when faced with the decision I outlined. 
Again, I was at a shelter, alone, about 3/4 mile *downhill* from the AT. In 
late July that year the northbounders had all passed through this area. 
It's possible no one would come down off the trail for a few days. If I 
wished to be helped I would have to get myself up to the trail. Exerting 
myself under these conditions would increase blood flow no matter which 
limb was bit, or what I did in the way of restricting blood flow with a 
bandana. The increased blood flow, I believe, would flood my system with 
toxin and create a much more severe reaction to the bite than if I simply 
stayed still for awhile. For lack of more evidence I think it would be 
deadly for me to move uphill like that with a severe envenomated bite from 
a rattlesnake. A bite from a copperhead, even if severe, is not likely to 
result in death (but there will be tissue necrosis).

In this situation it seems best to evaluate the severity of the bite, wait 
until I have clear evidence of how the situation is going to play out, and 
then make some decisions about getting myself out of there or staying put 
for awhile. I found it interesting that cutting, suctioning are not 
worthwhile options for the amount of help that they offer. I took comfort 
in realizing that the odds of death from the bite are between 1:500 and 
1:1000. That's a pretty good survival rate considering that many of those 
7000 - 8000 bite victims are intoxicated, perhaps older, perhaps 
out-of-shape, perhaps with complicating health problems like diabetes, 
heart disease, etc.

If others are knowledgeable about these metabolic things I think an 
underlying question might relate to the swelling that occurs when bit. Once 
the area is swollen it seems likely that free circulation of the venom 
isn't possible or it's greatly reduced. That's the reason for waiting - let 
the area swell up and allow the reaction to be local rather than forcing a 
systemic reaction by doing something right away. Those who are bee bite 
sensitive know the difference between these reactions.

Does that clarify things? --RockDancer

On Wednesday, February 11, 2004 5:52 PM, W F Thorneloe 
[SMTP:thornel@attglobal.net] wrote:
| Jeff Hunter adds his $0.02 with "One thing I would NOT do, is remain in 
the
| woods for several days (and thankfully, you don't have to along the 
crowded
| AT) as recommended below. Especially if you have the misfortune of being
| envenomated by a Timber Rattlesnake. That sort of decision can get you 
killed."
|
| He is exactly correct. Rattlesnake bite = trip to ER and probably to ICU, 
| at least overnight. I'm not aware we have neurotoxic rattlers on the east 
| coast yet, but the hemotoxins are a real problem.
|
| If you get bit, you do your best to immobilize the site and limb of the
| bite and get yourself evacuated. If you are alone, you do the best you 
can.
| If you have others, you work with them to assist your removal to medical
| attention. This is an excellent reason to keep a whistle handy.
|
| Remember that the most common features associated with rattler bites
| involve testosterone poisoning, elevated blood alcohol levels and the
| desire to demonstrate bravado. Most commonly, the 3 words uttered before
| the bite are "Hey, looky this!" These victims aren't specific to any
| geographic or cultural origin, but no one usually wants to claim them.
|
| OrangeBug
|