June 29, 2015

Snakes are a relatively common inhabitant of the United States and abroad. They are an uncommon cause of injury overall but young boys and men are the most likely to be bitten based on their risk taking behavior.

North Carolina leads the United States in cases of venomous snake bites. In 2010 there were 228 snake bites from venomous snakes state wide. The most common venomous snake is the copperhead which is found in every county in NC. Other venomous snakes include the cottonmouth/water moccasin, rattlesnake and coral snake. These other snakes are found more commonly in the coastal areas and the mountains.

Bites usually occur when a barefooted person stumbles upon a snake and startles it in to action or when we attempt to play with or kill a snake. Some snakes warn us of their presence by shaking a rattle although human selection is killing the rattlesnakes that have loud rattles and quieter bretheren are procreating when they are left alone to survive.

Many snakebites are dry strikes without envenomation. When venom is introduced into the skin the area will swell and become painful. Death is very rare with less than 20 per year country wide.

Most snakes are not aggressive, however, when you walk on trails watch for relaxing snakes. Stay out of tall grass where possible and wear boots when hiking.

If one does get bitten -

Advice from NC State Coop Extension:

Stay calm, get safely away from the snake, and have someone call 9-1-1 (or the emergency number in your area). The less the victim moves the bitten site, the less likely the venom will be spread through the body and cause damage.

Have the victim lie down with the affected limb lower than the heart. Keep the limb immobilized. If practical, splint the limb.

Treat for shock and preserve body heat.

Remove any rings, bracelets, boots, or other restricting items from the bitten extremity. (It WILL swell.)

Apply a light constricting band about 2" above and below the bite, however never place the bands on either side of a joint (such as above and below the knee or elbow). This band should be made up of wide, soft material, which could be a handkerchief or shredded clothing. The band should only be as tight as the band the nurse applies when taking a blood test.

NOTE: The purpose of constricting bands is to restrict lymphatic flow, not blood, so they should not be too tight.

Check pulses below the bands and readjust the bands as necessary when they tighten due to swelling.

Wash the bite with soap and water (if available).

If the victim has to walk out, sit calmly for 20-30 minutes to let the venom localize at the site, then proceed calmly to the nearest source of help and try to avoid unnecessary exertion which will stimulate circulation of the venom.

Get the victim to definitive medical care for antivenin, which will provide the greatest relief from the toxic effects of the bite.


DO NOT cut the bite. The additional tissue damage may actually increase the diffusion of the toxins throughout the body.

DO NOT apply a tourniquet. Such action can re
sult in the loss of the limb.

NEVER try to suck out the venom by mouth. You can try the suction cup in a snakebite kit if it doesn't delay other needed treatment. Suctioning seldom provides any measurable advantages, however.

Do not apply cold and/or ice packs. Recent studies indicate that application of cold or ice makes the injury much worse.

All this being said, snakes are part of the natural balance of the ecosystem. Most snakes are useful for controlling rodent populations. Try not to kill them out of fear and just walk away.

Once bitten, twice shy,

Dr. M