Rattlesnakes - what to do if you're bitten?

General discussions on hiking in Oregon and the Pacific Northwest
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romann
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Rattlesnakes - what to do if you're bitten?

Post by romann » June 3rd, 2010, 4:25 pm

We have a good thread about ticks now and then, but we had much fewer discussions about rattlesnakes. I know they're not aggressive and won't attack first, but it's also a good chance to step on them while hiking. Once you get bitten, the rules call for you to lay down and get help asap - but if you're backpacking a day or two from your car, in an area with no cellphone coverage, what will you do? Did anyone ever have been bitten while hiking?

Before hiking in Mill Creek Wilderness (Central Oregon) last week, I got a simple device from WalMart, consisting of a suction device, a blade, and a cord. I think a vaccine would be more efficient though, but it doesn't look that retail stores carry it.

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Grannyhiker
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Re: Rattlesnakes - what to do if you're bitten?

Post by Grannyhiker » June 3rd, 2010, 5:39 pm

I'm taking a Wilderness First Aid class this weekend, so may have more to report on Monday.

In the meantime, I've been updating my knowledge annually with my-son-in-law-the-ER-physician. He did his residency in southern California so had lots of experience with rattlesnake bite.

Here is the latest on snake bites:

First of all, only about 50% of snake bites are envenomated. You'll know if you are because if there's venom there'll immediately be lots of pain and prompt swelling. But that means that for the other 50% you just clean the wound (puncture wounds are very vulnerable to infection) and can self-evacuate. Do get yourself out to seek medical attention because of the danger of infection. Snake saliva is not exactly a germ-free substance!

For those bites that are envenomated, resulting in severe pain and prompt swelling, the following treatments are definitely NOT recommended. They don't remove enough venom to help and do cause severe tissue damage, infection and often gangrene around the bite. The blood vessels around the bite are already considerably weakened by the venom and the old-fashioned treatments only make things much worse. These include all the old remedies we were once taught, such as tourniquet, cut and suck, Sawyer extractor, ice, etc. You clean the wound, stay still and keep the limb level with the body. If you have a PLB or a SPOT (a good idea if you are out alone), it's very definitely time to push the button!

Prevention, of course, is the best cure. Look before reaching for handholds, before sitting down, look under logs before stepping over them, etc. It's helpful to remember that most of the deaths from snakebite are in young adults (mostly male) of the "hey, look at me!" variety.

When searching online for any medical knowledge, do NOT trust any entries that are not dated. Medical treatments change (as witness snakebite), and there's a lot of old, out-of-date information on the internet--as I found when researching this topic several years ago. Stick with the reputable medical information sites.

As mentioned, I may have more info to pass on Monday!

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Re: Rattlesnakes - what to do if you're bitten?

Post by ElphabaNorthWest » June 3rd, 2010, 6:47 pm

I asked my vet about rattlesnake bites and she said the antivenene is not a cure and it isn't a vaccine in the true sense of the word. It is the serum from a horse that has built up a tolerance to a particular snake type. You still have to get your dog (and I'm assuming the same applies to humans) to the vet as soon as possible. She told me that it is okay for a human to walk slowly (not run since you don't want to get your heart rate up.) back down the trail if necessary, so she guesses it would be okay for a dog also. I don't think pushing a spot/beacon would be much help, since it takes several hours to get a rescue going. As I understand it, you really want to get to a hospital as quickly as possible.
She told me most large dogs (and I'm guessing humans, since they are bigger) will recover even without treatment, but still get them as quickly as possible to a vet. There is nothing you can do on the trail that would help, so just get out of there.

pdxgene
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Re: Rattlesnakes - what to do if you're bitten?

Post by pdxgene » June 3rd, 2010, 7:53 pm

From Sullivan's Central Oregon book..
'our rattlesnakes are genuinely rare and shy -- and they never were as venomous as the Southwest's famous rattlers.'
So it doesn't really sound like they are really much to worry about.

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chameleon
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Re: Rattlesnakes - what to do if you're bitten?

Post by chameleon » June 3rd, 2010, 8:50 pm

Romann...I actually had that exact thing happen to me. It was about 8 years ago now...I recounted this story in a thread a long time ago, and I don't know how to find it in the archives, but here's a condensed version of what happened.

I was planning to spend the summer backpacking and photographing in the Selway/Bitterroot area. I had been in the woods for 8 or 9 days when it happened. I had fallen into a stream while photographing a waterfall. However, it was a sunny day, so I decided to take my boots off to let them dry for an hour or two. So, I put on my soft watershoes and headed up the trail camera in hand to spend some time exploring while the boots dried.

On my way back down the trail, I was moving quickly and quietly through a shaded area with over-grown ferns next to a muddy trickle crossing the trail when I felt something lightly grab the back of my ankle. I turned, and much to my chagrin, that "light grab" was the feeling of a rattlesnake sinking its fangs into my achilles tendon. It was black/green - a melanistic northern pacific rattlesnake - about 4 ft (ten buttons on the rattle) that I must have scared to death and panicked as I jogged past. It must have been right under a fern getting a drink or something to not have heard my approach.

I killed the snake, (and still have the rattle) and put it in a bag, since at the time I believed you needed that for the doctors when you get out (a myth though). Then I assessed the situation. I was 13 miles in and alone. My immediate thought was a really stupid one. I started back toward the trailhead, when seemingly miraculously a group of rafters landed on the river below. I rushed down to them to see if they could help. They couldn't do much. There were class 4 rapids on the way out, and didn't feel comforable rafting me out, and were planning to spend the night anyway. They offered to let me camp with them and they could at least offer me company overnight.

It was dumb, but I stayed with them. Physically, this is what occurred...about 5 minutes after the bite, there was a tightening in the immediate area. Then about an hour later my lips and nose strangely went numb. As the night progressed, swelling began and spread up my leg. After a restless night, I arose early and could barely shove my foot into my boot anymore. Also, the muscles in my legs had swollen and tightened so much that I could hardly bend my knee and each step was agony. Still I knew what I had to do - get the hell out of dodge. So, after deciding to give the snake to my weed-smoking new rafter friends - except for the rattle that I cut off and put in my pocket (who said they were going to skin it), I broke two long branches for crutches/walking sticks, made my goodbyes, loaded up my 50lb pack and headed out.

It was a long, horrible day. Early in the season, there were no other hikers on the trail. The hours passed slowly as each step became more and more painful. A few hours in, I saw my rafter buddy's float by on the river below. I replayed entire movies in my mind, reciting lines and singing the songs, to keep my mind from panic. Some hours in, breathing became hard and I became light-headed. I was tormented not only by the pain, but by a new sensitivity as well. Every time something tapped my leg or I heard a rattle in the bushes nearby (which occurred a few times) my mind freaked. At some point, I realized that I might survive this bite, but if I got bit again I'd be screwed. So I cut up my sleeping pad and used twine to tie pieces around my legs to prevent another freak encounter.

About three miles from the trailhead, I felt like I was going to pass out. I'd been choking down pain-reilevers and trying to drink and eat, but usually just threw it back up. I truly felt like the end was near as I hit a small stream. I began to yell for help as one last act on earth. I really didn't know what would happen if I lost consciousness. But of course, no one could hear me. I was still miles from the trailhead and next to a huge rushing river that drowned out my useless cries. As I debated what to do, I sat down on the river bank and put my huge swollen leg into the cold water, relishing the brief numbness that resulted.

Eventually I decided, well if I'm going to die, I'd rather be moving when it happens, than lying next to the river having given up. Goofily, it seemed like a matter of honor. Miracle of miracles though... shortly thereafter I ran into three hikers, one of which helped me struggle all the way back to the trailhead, at which point he sat with me for 30 minutes as I tried to regain enough cognizance to drive out. Though I didn't really feel it, I told him I'd make it...got into my car, and began off. Zooming along the rough washboard, no longer giving a dam about my shocks, I vomitted all over the dashboard, and pulled into a forest service bunkhouse.

Long story short, I spent 3 days in the hospital. After initial tests, the doctor said..."well, your liver's failing, your kidneys are failing, there's blood in your urine, your blood is not coagulating, and your blood sugar is super high because your body is digesting decaying tissues...other than that you're doing pretty good." I spent the next 6 months watching as my entire leg turned purple, then black, and then finally new tissues began to grow. During that time, the pain was excrutiating though. So much of the tissue in my leg had been severely damaged, that if I so much as lowered it below my heart, the pressure of the blood entering it was more than I could bear. I very nearly passed out a couple occasions trying to stand. So, I basically just would roll out of bed in the morning and literally pull myself across the floor like a lizard for 3 or 4 months. Thank goodness for my wonderful parents who helped me during the whole time.

So to get back to your intial inquest...yeah, its rare, and not every bite puts that much venom in, etc... but it certainly CAN happen. A bit like getting struck by lightning I suppose. But if you're in that situation, perhaps my story has some lessons in it you can learn from.

-Zach

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Re: Rattlesnakes - what to do if you're bitten?

Post by pablo » June 3rd, 2010, 9:35 pm

chameleon wrote:
... ouch ...

So to get back to your intial inquest...yeah, its rare, and not every bite puts that much venom in, etc... but it certainly CAN happen. A bit like getting struck by lightning I suppose. But if you're in that situation, perhaps my story has some lessons in it you can learn from.

-Zach
Zach,

That's a great story, thanks for sharing it. Hey, you hiked out 13 miles with a pack and a snake bite and spent the night, drove back, and survived - that to me is encouraging should something similar happen to me.

After my first encounter in Idaho with a rattler I sent off money to a place in Louisiana for a pair of rattlesnake chaps. Wore them once, they're still in the trunk of my car.

--Paul
The future's uncertain and the end is always near.

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Re: Rattlesnakes - what to do if you're bitten?

Post by cfm » June 3rd, 2010, 9:51 pm

Wow Zach! We are all glad you survived, and hey at least you got that out of the way now.


Paul, I'd like to see a picture of those chaps- are they just like cowboy chaps, or do they have extra coverage down low?

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chameleon
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Re: Rattlesnakes - what to do if you're bitten?

Post by chameleon » June 3rd, 2010, 10:03 pm

Paul, yeah... I researched it pretty heavily afterward, and you usually have a really good chance of making it. I hit some bad breaks, and I still made it. I just happened to panic a large, healthy snake, who hit me with what must have been a large amount of venom. In most bite cases, the snakes don't inject any venom, or very little. Adult rattlers it seems have the ability to control the amount of venom they inject. They won't hit you with much generally if they just want you to leave them alone. They need it afterall to acquire their next meal. It's only when they panic that they'll really unload in you. This is sometimes why young snakes are said to be more dangerous. There's a myth that their venom is more toxic. However, it's not. It's just that they don't yet have the ability to adjust the amount they inject. They just hit you (or usually a toad, rodent, etc...) with all they've got.

Also, you shouldn't move as much as I did. Hiking mile after mile with a heavy pack might have saved my leg (by not trapping the poison in my leg), but taxed my liver and kidneys it seems, as well as my heart and respiratory system.

Additionally, I no doubt took way too many pain relievers. One thing you should not do is take aspirin or ibuprofen. (I took a bunch of ibuprofen) Rattler venom is a powerful anit-coagulant (prevents your blood from clotting), and ibuprofen and aspirin can exacerbate this, as they do the same thing (to a lesser degree of course). So, take tylenol, but don't overdo it. The poison will require the full ability of your kidneys and liver, and too much pain reliever will help to overload it.

So, really the best advice is move methodically toward help, drink lots of water, don't take any pills or pain reliever if you can avoid it, and just tell yourself that you're going to make it. Don't panic. The odds are in your favor.

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Charley
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Re: Rattlesnakes - what to do if you're bitten?

Post by Charley » June 3rd, 2010, 11:17 pm

That's incredible. Thanks so much for sharing. You're a hero.
Believe it or not, I barely ever ride a mountain bike.

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chameleon
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Re: Rattlesnakes - what to do if you're bitten?

Post by chameleon » June 3rd, 2010, 11:37 pm

Ha...thanks Charley, but nothing heroic about that. It was just an experience that I had and have learned from. I made a lot of mistakes with the situation - the biggest was deciding to spend the night. I should have just kept hiking when the rafters couldn't help - but I was panicked, and truthfully...needed the human interaction as much as anything. In any case, it was an encounter I'll probably always remember (and hope it doesn't happen again!).

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