Wilderness Medicine for Wildlife Photographers: Snake Bites
Given the season, given that spring has sprung and wildlife photographers all over the northern hemisphere are beginning to emerge from their winter hibernation and go forth into the wilds once again, this installment will focus on a particular topic that seems to haunt many people.
Western Diamondback Rattlesnake. © Jared Lloyd
On nearly every list of “most common fears,” you will find a very obscure sounding word: Ophidiophobia – the fear of snakes.
While this article is not about the rationality of this phobia, it is about snakes and snake bites.
Be honest, you’ve thought about this haven’t you?
It’s likely you’ve found yourself hiking through tall grass, wandering off trail in the woods, or trudging about some other place where the possibility of snakes has slithered itself into your thoughts.
Yet, despite this fact, most people either have no idea what to do if they were to be bitten by a snake or their understanding of it is so antiquated that they can cause serious harm to themselves or others in this situation.
And so, in this installment of Wilderness Medicine for Wildlife Photographers, we are going to discuss snake bites.
I’m part of a strange subculture of people across North America that absolutely loves snakes. While my partner, Annalise, talks about “birding,” I grew up “herping,” – as in herpetology (the study of reptiles and amphibians).
I hate to say it, but I’ve been bitten by a lot of snakes.
I think the running total is something like 48 times. The last time was when I first met Annalise and I tried to impress her, not realizing she would have been more impressed if I had just identified a new species of bird for her. Yes, I know this was stupid but at least it wasn’t preceded by saying “hold my beer,” or “hey ‘y’all’ watch this,” as I attempted to do a backflip off the roof of a single wide trailer.
We all evolve.
Probably the craziest of my snake bites was from a green anaconda. This was, of course, my fault. I picked her up. I got what I deserved – meaning I’m a statistic. In fact, all but 1 of my snake bites came about from me picking up snakes (and you thought two degrees meant I was smart).
The one time I was bitten by a snake from no fault of mine, however, did happen to be a venomous species.
When I was in college, I fell in love with fly fishing. I trekked all over the Southern Appalachian Mountains with camera equipment in the cab of my Toyota Tacoma and fly-fishing gear in the back.
One day, I parked along the edge of a dirt road in the national forest and began the hike down into a steep gorge with visions of fat rainbow trout dancing in my head. It was a bit of a slog getting down there. Whatever trail I was supposedly following had long since evolved into a more feral version of itself, likely used by little more than black bears and whitetail.
Nearly to the river, I felt something hit my calf just above the wading boots. I spun around and saw a copperhead desperately trying to flee the scene of the crime. Looking down at my leg, there was the tale-tell bite mark of a pit viper: two obvious holes that were already red and swelling.
This was the good-old-days, back before smart phones and 5G reception, when you could still spend an entire day exploring without ever getting cell phone service. Naturally there was a moment in which I debated still trying to get to the river to fish. But alas, my better judgement won out and I began the hike straight back up the hillside.
This isn’t something we typically recommend with wilderness medicine. The last thing you want to do is to get your heart rate up, helping the venom spread through your body faster. But there was no cell reception. The iridium satellite network did not yet exist. Garmin inReach had yet to be invented. And hiking out was the only option.
And so, I hiked. I climbed. I trudged my way back to my truck, pausing to assess myself, to see if the redness around the bite had spread. By this time in my life, I was a Wilderness First Responder with all the advanced medical training that specifically focused on what to do when things went sideways in the middle of nowhere. So, before I began the hike up, I took a felt tipped marker out of my first aid kit and drew a circle around the bite so I could see if the swelling was spreading.
Northern Copperhead. © Jared Lloyd
Copperheads are pit vipers and therefore produce a hemotoxic venom. The venom is like a chemical grenade that goes off inside your circulatory system made of all sorts of noxious and deadly proteins. In some places, your blood may begin to clot and staunch flow. In other places, you begin to hemorrhage. This is the type of venom found in species such as copperheads, cottonmouths, rattlesnakes, and nearly every species across the Western Hemisphere.
A hemotoxin is different from the other type of venom one may encounter from snakes, which is neurotoxic venom. As the name suggests, neurotoxic venom attacks your nervous system. This is found coral snakes, cobras, and the rest of the world’s deadliest venomous snakes.
Given the hemotoxic nature of the venom, swelling and bruising was something I wanted to monitor closely – hence the marker. This could help indicate the degree in which the venom was spreading, how much venom had been delivered, and could potentially serve as something of a barometer for the “I’m-Screwed-O-Meter.”
While drawing circles on someone isn’t exactly standard practice for something like this, I was attempting to “self-rescue.” I knew I was pushing my heart rate up to 140bpm or higher. And so I was trying to be as resourceful and thorough as possible; doing my best to check vitals, swelling, and taking a few notes about myself along the way.
By the time I made it to my truck, roughly 45 minutes had elapsed. Throwing my pack into the bed, I climbed in, shifted the transmission into first, and began the drive out of the forest to the hospital in Boone, North Carolina.
There was still no cell reception, of course. And the drive back to town took another 30 minutes. So, when I pulled into the parking lot at the ER, checked the swelling and my vitals once more, trying to account for the anxiety of the situation, I concluded that it had been nothing more than a dry bite and there was no reason to bother the good people of the ER with this.
In other words, I was lucky.
Dry bites are common. Dry bites happen when the snake chooses not to use venom. Defensive bites are designed to give you a good punch to the gut and buy the snake some time to get out of there. Not all defensive bites are dry, of course. But many are because the production of that venom is so costly to the snake to begin with.
Let’s talk statistics here for a moment.
• 45,000 people are bitten by snakes across North America every year.
• 8,000 of these are from venomous snakes
• 30-50% of all bites from venomous snakes are classified as “dry.”
• On average 5 people die each year from venomous snake bites.
• 4 out of 5 of those deaths are people who were holding or trying to capture the venomous snake when they were bitten.
• On average only 1 person dies a year in North America from being bitten by a venomous snake they were not trying to pick up or harass.
With just shy of 400 million people running around North America, these are pretty good odds that suggest you will likely not die this year from a venomous snake.
Venom is not a weapon to be wielded like a big set of horns or antlers. Venom in snakes evolved to help immobilize prey, not chase down and kill wildlife photographers. The production of this stuff is costly in terms of calories. And it can take weeks, depending on the amount that is used, to resupply. This makes it a very precious resource. One that needs to be closely guarded, used sparingly, and rationed. When a snake injects venom, they do so with the understanding that the consequence could be weeks before they will be able to eat again as a result.
Yet, envenomation does occur, probably more often than not.
While the vast majority of those who are bitten don’t succumb to the venom, it’s important for us to know what to do if this situation happens to us or someone we come across while in the field.
Eyelash Palm Viper. © Jared Lloyd
Jumping Viper. © Jared Lloyd
IMPORTANT. Despite popular misconception, never cut or suck on a snake bite. Nor do you want to use a torniquet. These are pervasive myths that Hollywood seems to be dead set on helping to perpetuate. While there are various contraptions on the market that purportedly “help” pull the venom out of a snake bite when used within a minute of the bite, the efficacy of these things is still controversial and so the recommended guidelines are to not waste your time with these. And with a tourniquet, we all but ensure the person will lose a limb from the ordeal.
Rattlesnakes, Cottonmouths, Copperheads, and the Fer-de-lance: hemotoxic venom
Signs and symptoms of envenomation:
• Swelling, pain, and tingling at the bite site
• Tingling and a metallic taste in the mouth
• Fever
• Chills,
• Nausea,
• Vomiting,
• Blurred vision
• Muscle Tremors
The #1 goal is rapid transport to a hospital for evaluation. This means that the very first thing you do is call for help with your cell phone or Garmin inReach device.
But while waiting for or assisting in the evacuation:
• Gently clean the wound with antiseptic soap
• Apply sterile dressing.
• Keep the affected limb at heart level or higher*
• Keep patient quiet, hydrated, and comfortable.
• Remove any jewelry or items that could become constrictive if extreme swelling where to occur ANYWHERE on the body.
• Give pain medication BUT NOT ASPRIN due to its anticoagulation properties.
*Until recently, we were taught to keep the affected limb below the heart. This is no longer the case. The amount of venom injected into the body is so small that raising or lowering it will not have a real impact upon how fast the venom spreads. However, 95% of all hemotoxic bites result in tissue damage. For most snake bite victims, the tissue damage around where they were bitten will be the only real damage done. Keeping the limb elevated therefore helps to reduce the hydrostatic pressure that plays a big role in that tissue damage. For that reason, elevation is now the new normal.
Activity only accelerates the absorption of venom. So too does anxiety. This means that you or the victim needs to stay immobilized if at all possible. Trying to walk out is only an option if there are no other alternatives.
Healthy adults generally do not die from hemotoxic snake bites. More problems are created from misguided and misinformed attempts at helping. Pressure bandages will result in hemotoxic venom being isolated and concentrated in one area which can result in extreme tissue damage. Torniquets result in the loss of limbs. And cutting the skin is something that only should occur if swelling is so extreme that it becomes life threatening or may burst open.
Texas Coral Snake. © Scott Delony
Coral Snakes in the US, cobras, mambas, kraits, Australian brown snakes, tiger snakes, death adders, etc. – neurotoxic venom
Across the United States, there are three species of snakes officially classified as neurotoxic: all of them coral snakes.
Signs and symptoms of envenomation
It’s important to understand that with a neurotoxic species, these signs can sometimes take several hours after a bite occurs before these begin to occur, and with coral snake symptoms have been documented to take up to 12 hours to begin.
• Drowsiness
• Weakness
• Nausea
• Rapid pulse
• Rapid respiration
• Pins and needles
• Numbness
• Respiratory failure
• Altered mental status
• Unresponsiveness
• Blurred vision
• Paralysis
• Seizures
• Heart failure
Treatment for a neurotoxic envenomation is exactly the same as with hemotoxic species but with one very big difference: the use of pressure bandages.
To slow venom absorption, the limb that was bitten should be splinted and wrapped tight with a wide elastic bandage such as an Ace bandage. You do not want to create a torniquet with this, however. While the wrap needs to be as tight as possible, you should still be able to detect a pulse below the wrap someplace.
A friend and colleague of mine was bitten by a coral snake in Honduras several years ago. He too was a statistic because he picked up the snake after misidentifying the species as a harmless Honduran milk snake. He was holding the snake while attempting to photograph a manakin lek in the forest when the snake bit him on the arm. Snake bites happen when you pick up snakes, of course. The snake struck again, and he thought nothing of this. Then finally, the coral snake bit him between his fingers, didn’t let go, and began digging its teeth into his flesh. This was not your typical milk snake behavior. My friend had a lifetime of experience working with snakes and as soon as the snake latched down onto his hand, he realized he had made a grave error.
Almost immediately his lips began to go numb and his hand became pins and needles. His assistant called in a helicopter to the closest clearing in the forest. While being airlifted to Roatan Island from the mainland for treatment, he slipped into a coma. The doctors administered the entire country’s supply of antivenom effective for coral snake bites. Four days later he woke up in the hospital where the doctor told him he couldn’t believe he was alive.
Neurotoxic venom is powerful stuff.
While Eurasia, Africa, and Australia play home to a litany of neurotoxic species, in the Western Hemisphere we only have the coral snake to contend with - though there are more than 70 different species on this side of the world.
If you’ve heard the rhyme, “red on black, friend of Jack; red on yellow, kill a fellow,” or some variation of this, it was created to help differentiate between milk snakes and coral snakes when in the field.
However, this only applies to the coral snakes in the United States. The other 70 odd species found throughout Latin America don’t hold up to this – as my friend in Honduras discovered the hard way.
With all of this said, however, a bite from a coral snake is extremely rare. The rarity of this is why the entire coral snake antivenom supply of Honduras was used on my friend. And of every documented case I can find of coral snake envenomation in the United States, 100% of them were because people picked them up.
Honduran Milk Snake. © Jared Lloyd
The thing about evolution, the thing about an animal developing chemical weapons, is that things change. Traditionally, we classified all rattlesnakes as hemotoxic. I stated this fact above. However, research now suggests that some species, such as the timber rattlesnake, are beginning to evolve neurotoxic properties to their venom.
We could ty to speculate as to why this is. Evolution is typically a matter of push and pull, as many factors are working on life at the same time. Some populations of rattlesnakes rarely use their rattles, for instance. All of these populations are in areas where “rattlesnake roundups” are commonplace. The fact that snakes in these areas are growing quiet suggest we are unnaturally selecting for quieter rattlesnakes in the wild since it’s the tell-tale-buzz that gives them away and leads to their immanent death thanks to these blood sports.
All of this could lead me to speculate that we may be helping to drive timber rattlesnake venom toward neurotoxic thanks to fragmented habitat and decreased biodiversity. The most potent venoms on Earth exist within species that have the most to lose if a meal gets away. Think of sweeping desert of interior Australia, where so many of the most venomous species on planet live. When food is scarce, a snake needs its venom to drop its prey as fast as possible. And this is exactly what neurotoxic venom has evolved to do.
When it comes to handling snake bites, we can distill everything down to a few basic concepts to make it easy to remember:
1. Make sure you are in a safe position to help yourself or someone else (meaning, getting away from the snake is the first priority).
2. Begin working on an evacuation. Cell phones, Garmin inReach, or an Emergency Beacon.
3. Clean and sterilize the wound.
4. Monitor for symptoms
5. Keep everyone calm and still – if possible
6. Keep the injured limb above the heart if possible
7. Keep the victim hydrated
This discussion, of course, falls far outside of the typical wildlife photography conversations. This shouldn’t be the case, however. Staying safe while in the field, knowing what to do when that proverbial you-know-what hits the fan, being able to assist someone else you come across in a bad situation, is important if you are going to spend time in nature.
Backpackers, kayakers, rock-climbers, and even avid hikers typically understand the importance of having some understanding and training in wilderness medicine. Much like CPR and First-Aid are designed to have a very low bar of entry so more people have this knowledge, wilderness medicine is similar in this respect.
Wilderness First-Aid is something I highly recommend any wildlife photographer who wanders off the side of the road look into for themselves.
You can go further with training to become a Wilderness First Responder or Wilderness EMT, of course. However, these are more applicable to people who are outdoor professionals, guides, and workshop leaders.
Remember, knowledge is power.
Stay safe out there!