snakebite

There are four types of venomous snakes in the United States: the several species of rattlesnakes, the cottonmouth (water moccasin), and copperhead make up the pit vipers (of the family Crotalidae), and two species of coral snakes (family Elapidae).

In the United States, the great majority of snakebites involve rattlesnakes - about 95 percent of the estimated 8,000 snakebites per year. Of these 6,000, only about 12 per year are fatal. Most bites are accidental, occuring during work around the yard, hiking in the woods, or other activities where the snake is not noticed and is disturbed in its habitat - for example, reaching into a hollow burrow or tree trunk, or stepping over a large log without seeing a snake resting on the other side.

Snake venom has effects toxic to both the blood and nervous system. Pit viper toxin is largely hemotoxic, damaging the blood by causing red cell breakdown (hemolysis), whereas coral snake venom is largely neurotoxic, attacking the nervous system. Symptoms of envenomation include pain and swelling at the site of the bite, weakness, numbness or tingling, rapid heart rate, vomiting, and shock.

First aid involves immobilization and splinting of the bitten extremity, application of a broad, low pressure tourniquet, and immediate transport to an emergency department for antivenin therapy. Close observation and life support are critical. Some bites require surgical decompression of swollen tissues.

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