Bites

Western Rattlesnake-

     The most common poisonous snake in the Sierra Nevada Mountain is the Western Rattlesnake (subspecies. Northern Pacific/Great Basin). It is normally seen at around 2,000 to 7,000ft elevation but has been noted much higher. This species grows to be 4 to 6 feet long and is responsible for more  US deaths by snakebite. This species of rattler can be identified by the series of black and white bands next to their rattle. It is thought that 20-25% of all poisonous bites are "dry" bites where they do not release any venom. This number is only an estimation because of the lack of reporting all suspected bites however, when a Western Rattlesnake does envenomate, they give the largest doses of all the rattlers. The percentages below are an average between the Northern Pacific and Great Basin Rattlers since they both are subspecies of the Western Rattler. It has been noted that there has been an increased toxicity of venom with the neurotoxic percentage increasing compared to decades ago. There are two existing theories one, the snakes are interspecies breeding giving more toxicity to the lesser toxic species and/or the coevolution of predator and prey with snakes with more neurotoxins being able to feed on hemotoxin resistant rodents giving them the survival edge.             Some scientists believe this to be "rubbish" and attribute the toxicity to the cocktail that one species might have compared to another given their greographical location and terrain. This theory has shown some weight when comparing the toxicity of the yellow belly sea snake compared to a venomous grassland snake (rattlsnake).  A sea snake must be able to incapcitate their prey quickly so not to lose them since following a scent trail would not be feasible in the water as compared to the open grasslands.  Regardless of any theory what is known as fact is that physicans are having to give more antivenon then ever before. What I think the average Joe should  take from this is by being aware of the environment you are surrounded by could give you insight as to the potential level of toxicity of the venomous animals within your immediate area.

 

Justin Rattlesnake Bite

In July of 2002 13 year old Justin was in the Yosemite National Park surrounded by his friends enjoying the beauty of the park and getting in some rock climbing. He was sitting on a boulder with his arms dangling at his side when a 5 ft Northern Pacific Rattler had bitten his left palm.  It took 4 hours to get him 4.5 miles to the trailhead where a helicopter was awaiting him.  During the 30 minute ride he was having trouble keeping his eyes open and staying conscious. Upon arrival to the Modesto hospital it was determined that the bite was too severe to be treated in Modesto so he was sent to the UC Davis Medical Center in Sacramento California. He had gone unconscious prior to arrival.  He was given a total of 30 vials of antivenon within the next two days starting in Modesto and ending at UC Davis.  Upon arrival to UC Davis it was determined that a faciotomy would be indicated to relieve the pressure of the muscle swelling underneath the fascia. If not done immediately he could lose  his arm. He was rushed into the Operating Room where surgeons performed a fasciotomy opening up his arm from his palm to mid bicep.  

     After 30 days and 8 operations of cleaning and debriding the dead tissue from his arm he was ready for 2 more operations that took a skin graft from his leg to fill in the gap of debrided tissue to close his arm.  On August 24th he was released from UC Davis. After 4 months of rehab he flew to Duke Unviersity for a Free Flap surgery performed to transfer muscle and artery to the existing blood supply in his arm using microsurgery.  He would return to the Operating Room two more times in 24 hours for the repair of bleeding issues.  Despite the setbacks his graft was a success.  After 6 months of  occupational therapy he could move each finger 2-3 millimeters.  Twenty months later and  $700,000 of helicopter rides, surgeries and hospital stays he has full mobility  and 80% of his original strength.  Despite all that Justin had gone through he keeps a positive attitude and feels fortunate that his recovery did not lead to any significant loss. 

 

  

Venom

 

Hemotoxin-   53% of the venom is made up of a hemotoxin which enzymes are                 designed to attack the circulatory system causing circulatory                     collapse.              

 

Neurotoxin-  17% of the venom is designed to attack the nervous system which                 can create paralysis, drop in blood pressure, numbness and                       respiratory paralysis.

 

Proteolytics- 30% of the venom volume is composed of this which breaks down                 tissue to help with the digestive process. Localized tissue                         destruction is the main symptom.

 

     They normally feed on burrowing varmits so one should take notice when traveling in areas where burrows are seen. Rocks, crevices, fallen timber or anything they could hide under particularly fallen logs and high grass. Look for signs and tracks of activity of their prey. Care should be taken when stepping over logs and where you put your hands and feet. Even though the Western Rattlesnake has a rattle, it does not always warn the victim. Most cases of people being bitten were related to handling or harassing. It is wise to keep your distance since they can strike 2/3 the distance of their body and even farther if they are striking downhill. 

     An ounce of prevention is worth a pound of cure and being aware of areas where you might run into one is paramount in bite prevention. Understanding the behavior of rattlesnakes what they eat and where they like to live will help in the prevention of future potential snakebites. 

 

Story 

     I was hiking cross country heading to a new area when I came across this field of fallen trees.  A lot of fallen trees seemed old and rotting with high grass surrounding them. I looked down and took notice of the burrowed tunnels  in the grass as well as rat scat all about. I took the time to stay in place for the moment and observed the area to see what was taking place in this environment.  After a few minutes I decided that I would cross this area instead of adding time to my hike by circumventing this area.  I chose to walk on top of the fallen trees paying particular attention what laid alongside of them and to also take notice for any burrows.  I had gotten to my third fallen tree when I noticed about 25 feet in front of me a 4 ft long Western Rattlesnake slithering along through the grass going from one hiding spot to the next, she was at least 3.5 inches thick.  It was a fine specimen and I was quite surprised that it would be out at this time of day since the heat was so intense.  I pondered the idea that maybe I caught it in the middle of tracking its next meal.  Had I not paid attention to the signs, tracks and situation of the area I could of easily fallen victim to their bite.  If I had a gun I could of shot it but it would of not of taken away the poison after the fact.  It is better to identify and circumvent an unpleasant event rather than dealing with the repurcussions of being unaware. 

 

    Studies have shown that the most common population to be bitten by a snake is a young drunk male followed by children.  It is no surprise that alcohol, testosterone  and youth play a large role in snake bites.  It is the mixture of the three that brings the behavior of handling and harassing these magnificent reptiles into provocation of striking. Children however are just stepping and putting their little hands and feet in places where they dwell. 

 

   There have been many studies, natural remedies and medical treatments that have been tried throughout the years and of course with ever evolving knowledge of medicine and new data comes better and more updated treatments for snake bites. Let's start with the old treatments and why they have been outdated as well as new promising studies. Keep in mind that if you are in an area where it could be days before getting medical attention, treatement should be assessed on a case by case basis. 

 

 

Cut and Suck-

       There is an old joke about Tanto and the Lone Ranger are out in the                     wilderness when the Lone Ranger gets bitten by a rattler on his                           buttocks resulting in him also trapping his leg between two rocks. So the                 Lone Ranger sends his loyal companion to town for help. When he arrives                 in town he finds that the Dr. is in a very precarious procedure and                       cannot go back with Tanto so the Dr. tells him to go back and " Just                     cut between the fang marks and suck out the poison". With this new                     knowledge Tanto goes back into the wilderness. When he arrives the                     Lone Ranger asks Tanto what the Dr. had said. Tanto repied "Doc says                 your gonna die".

Suction Devices-

        These devices claim that you can draw out the venom by placing a suction cup           attached to a syringe.  Research data gathered from the use of these devices         have shown that it is not only ineffective in removing venom but that there was         a greater likelihood of causing an infection from it as well as waste precious             time. You will still find these snake bite kits with suction devices making claims         of high success rates but the scientific data shows likewise. 

Tourniquet-

        I first must urge that this should not be done by people not well versed in the                    application and monitoring of a touniquet and is soley for reading than application.

           Sierra Sasquatch® takes no responsibilites of harm of any nature to those                          attempting this technique. 

                

        The idea behind this treatment is to stop the venom from going beyond the             bite site and circulating throughout the system. I have heard physicians and             RNs state that they would try this and at this point I feel it not too                   unreasonable if the conditions warrant. I would only attempt this technique if           medical facilities are too far away to get to in a reasonable time. It should be         attempted only by those well versed in its use. For the average Joe it might           be more detrimental than helpful if the touniquet was not applied and monitored         correctly. A tourniquet might be applied just above the bite site with enough           pressure to disrupt the flow of the lymphatic system but not enough to stop             the flow of blood. This can be done by applying the tourniquet between the             heart and approximately 1 inch above the bite site. A pulse should be felt on           the farthest point of the affected limb with the bite between pulse felt and           heart to establish a baseline pulse strength prior to application of the                   tourniquet. As you are applying the tourniquet the pulse distal should be                 assessed until it is no longer is felt. Once a pulse is not longer felt it should           be backed off 1/2 to 3/4 turn. This will block the lymphatic system but still           allow blood to perfuse the affected limb. It shoud be understood that this will         only work on extremities bites and not where a tourniquet would not be feasible         to apply. Most bites occur on extremities so I felt it worthwhile to mention             this technique.

 

Compression Bandage-

                This technique is an alternative to a tourniquet and has shown promising                 results in Australia. The idea here is to prevent the venom from spreading               systemically. This technique was designed primarily for neurotoxins but has             shown promise with rattlsnake bites. Rattlesnake bites do have a component of         neurotoxins in their lethal venom cocktail. As with the tourniquet technique,             this should also be applied only by those well versed in the application and               maintenance of such a dressing. 

 

Splint and Elevation-

        This is what is widely recommended thoughout the medical community. A splint         is applied on the affected limb and kept below the level of the heart (this is to         help slow the process of the venom reaching the heart). The victim should be           kept as calm as possible so as to not raise the pulse rate which would facilitate         a faster spread of venom throughout system. The idea here is to immobilize             movement to slow the spread of venom. Alternatives should be sought than             having the pt transport themselves, (you want to keep the heartrate low                 thus decreasing chances of spreading venom). 

 

Wound Cleaning-

                 Infection is the most common complication of a snake bite whether it be dry 

         or envenomation took place. A snakes mouth can be very dirty placeif you                thinkabout the types of prey that they consume. The bacteria from the                tissues of rats, chipmunks, gophers and any other sort of burrow                        dwelling  rodent can be harbored and transferred via bite to its next victim.            Snakes teeth are of conical shape so when they penetrate the skin they go in          deep and normally close up the wound as they are released from the flesh              making for an anaerobic (oxygen free) environment. These types of wounds can          become infected quickly. Cats bites also infect quickly for the same reason. 

              The wound should be washed as soon as possible with warm soapy water            paying attention to broken teeth that still might be lodged in the wound. Apply          a clean dressing and seek medical attention as soon as possible.

 

Bringing it all together-

        The best treatment for snake bites is to avoid them.....being aware of         your environment and acting accordingly will save you great amounts of           time, pain, and money. If you do get bitten then this is what is                 recommended by the medical establishment.

 

1.  Remove them from the threat of the snake so they won't be bitten              again. Don't try to catch the snake, you could just be bitten. When you get    to the hospital they will do tests to decide what the  best treatment            options will be. If you remember what the snake looked like then tell them      if not, don't worry about it. 

 

2. Keep the victim calm by reassuring them, limit movement, and keep bite site    lower than the heart. Don't give stimulants, alcohol or drugs. Keep them as    still as possible and monitor for shock. Do what you can to prevent an            increased in heart rate. You want to slow the progress of venom in the          circulation.

 

3. Remove all jewelry and any binding types of clothing. If you are bitten on      the leg then take off your shoe. Expect a significant amount of swelling. If    the swelling is contained like in a shoe or if you have a ring on, it can create    circulatory issues to go along with your snake bite issues. 

 

4. Wash the wound with soapy water removing any dirt, debris or broken snake     teeth. Cover with a dry dressing. Do not apply ice to wound since it can         drive the venom deeper into the tissue. 

 

5. Splint the wound to contain movement. Avoid alcohol, caffeine or any other    drug that might speed up absorbing the venom by increasing heart rate.        Try to keep the affected limb below heart level. I am repeating this part      because of its importance. 

 

6. The keys to your car are your most valuable tool. Get to a hospital as soon     as possible. The faster you can get treated the better the outcome.

    Please don't hesitate by looking for the snake or contemplating whether you     need to go or not. If the snake was nonpoisonous or it was a dry bite great     no foul no harm but if you have been envenomated time will be on your           side.  

 

                                                                      Bee Stings

 

 

     About 100 people die from bee stings yearly in the US. An adult can tolerate up to 1,000 bee stings with a child being able to receive 500 at best. It is not the venom of the bee sting that can be so dangerous but rather the reaction that some have to the venom itself. Anaphlyactic shock takes place when the body reacts to the venom of a bee. It is a severe immune response flooding chemicals throughout the system causing a drop in blood pressure, rash, hives and swelling of the body including the airway. It is the closure of the airway through swelling within minutes that makes for a medical crisis. 

 

Treatement

     The victim should first be removed from the area immediately from any more bee stings. The body should be assessed for any stingers that might still be lodged in the body. Time is critical.  Even though the bee disembowels themselves in the process  leaving the stinger and vemon sack in place, it will continue to pump the venom until empty. You should not worry about squeezing the venom sack when removing or using a device to aid in removal. The longer the stinger is in place the more venom it will pump into the victim so it is paramount that all stingers be removed immediatley without regard to technique. The victim should be assessed for symptoms of anaphylactic shock to include: Rapid and weak pulse, rash, hives, nausea and vomitting difficulty in breathing. 

 

Remedies-

     There are a wide variety of remedies that have been passed down through generations that focus on removing the swelling. A simple remedy is icing the welts down decreasing pain. If you are in an area where ice is not an option then anything that dries the welt out. As a child we would use mud. As the mud would dry it would help draw out the histamine (fluid) from the welts. Histamine is the response to the bee sting.  Baking soda, toothpaste, rubbing alcohol, onions and even honey have claims of treating stings. Plaintain crushed and placed on a sting will help alleviate the pain by use of astringents within the plant that help draw the venom out. Any of these remedies have proven useful but are more effective the sooner that they are applied. 

 

Anaphylactic Shock-

     It is not the venom of the bee that can be fatal but rather the body's own reaction to the venom that can prove fatal. Assess the victim for change of conciousness, difficulty in breathing, hives and swelling on all  parts of the body. Remember that if you see one part of the body swelling up then the internal organs might be doing the same, mainly the trachea (windpipe) is of most concern. 

     Most people that are allergic to bee stings normally carry an autoinjector (epinephrine) pen with them. If you are allergic you should tell those with you and where the pen is. If they are unable to tell you then check them for it, time is critical so no need for being polite. Some might have it in the glove box of their car. Injections are designed for the outer thigh and not hands, feet, buttocks or fingers (please review manufacture directions). Once it is given seek medical attention immediately. 

 

Bringing it together-

 

Avoiding a bee sting is the best option, here are some ways to help:

 

-Avoid wearing colognes or perfumes.

-Avoid wearing bright colors or floral patterns. 

-Wear long sleeve shirts and pants with closed toe shoes. 

-Be aware when near flowers

-If you encounter a bee do not swat at them (It can provoke an attack).

-If attacked close your mouth and protect your eyes. Run to an area of           darkness if possible (garage or dark part of the forest) they have poor night   vision which will decrease intensity of attack. 

-Anaphylaxis does not always happen right away so continually assess for at       least 5 hours for anaphylactic symptoms. 

-If you do have allergies to bees make sure you carry an epi pen all of the       time. Make sure you let friends and family know prior to heading out.           Familiarizing yourself with the use of the epi pen prior to an event is             recommended. Family and friends should be aware of your allergy as well as     use and location of pen. Change pens when expired. Monitor pen for             cloudiness and discoloration of injector, replace as needed.  

 

                                 Spider Bites

 

Black Widow

     The Black Widow spider is a very reclusive species but when disturbed can give a very painful bite. The male like most spider species, is much smaller than the female and fangs are too small to cause harm. They are mostly tan/brown in color. the female can grow to around 1 1/2 inches in size has a black leather texture with a bright red hour glass symbol on their abdomen. It uses a neurotoxin to subdue their prey as well as a defense mechanism. No one has died in the US for over 10 years from a bite. The elderly and children are at most risk. Most bites are dry bites with no envenomation. Assessing the victim for symptoms shoud be continuous. Wash the wound with soap and water, ice, apply clean bandage with antibiotic ointment and elevate to limit swelling . Symptoms of envenomation include but are not limited to:

 

-Redness, pain and local swelling

-Abdominal Pain (can be similar to appendicitis) and generalized muscle cramps   to abdomen, shoulder and back. 

-Weakness, tremors or paralysis (especially in legs).

-Dizziness, Chest Pains, Respiratory difficulties and high blood pressure. 

                                                                       

Bringing it together

Black Widows are reclusive

-Most bites are dry bites

-No one has died of a bite for over ten years

-Elderly and Children are most susceptible

- Wash bite, apply antibioltic, wrap in clean dressing. 

-If bite is very painful, have difficulty breathing, paralysis, dial 911. Continue  to assess for symptoms. It is never a bad idea to go seek medical help even if  asymptomatic. 

 

When out be conscious of where you put your hands. Avoid dark places be aware of crevices with spider webbing. When picking up dead firewood shake wood to dislodge any spiders and do not hold wood against body when transporting. Be aware of where your are sitting down. 

 

There are other poisonous spiders in the Sierra Nevada Mountain Range but even though they might give a nasty and painful bite (possible necrosis) they area not considered lethal to humans so I have not acknowledged them here. Most instances of a spider bite was actually a bite from something else. If you do show symptoms of pain, necrotic lesion, difficulty breathing, rashes or hives seek medical attention to determine cause.