›› The Perils of Parenting

Learning to Live with Things that Bite
Part 2: Snakes

Margaret Morris, MD, FAAP
Chapel Hill Children’s Clinic

Snakes bite a few people in our area every year. Last summer, three patients in our practice were bitten by copperheads (all did fine). This spring, a man in Raleigh was bitten while working in his yard. Though these bites can be exceedingly painful, fatalities or even permanent disabilities are exceedingly rare, especially with proper medical care. Our region is fortunate in having only a few species of poisonous snakes. The most likely venomous snake to be encountered in this area is the copperhead, which, as venomous snakes go…well, they’re not the worst. There are also some species of rattlesnakes, though they are much less common. Coral snakes may be in our area, though we are at the edge of their range. But they are secretive and shy and account for very few snake bites.

The vast majority of snakes that we see are not venomous. NONE of the snakes around here wants to bother us, including the venomous ones. Snakes bite us for one of two reasons. We step too close to them, and they don’t feel they can escape; or we are deliberately and foolishly provoking the snake, and he strikes out.

Our snakes live in all kinds of habitats. They like areas where they can get food (rodents, bird and reptile eggs, birds, lizards, bugs, frogs, fish, other snakes), where they can hide, and where they can get warm if cold and get cool if hot. They like piles of rocks, fallen trees, piles of brush, areas of shade and sun.

Learning to live in a world with snakes is much like learning to live in a world with automobiles or hurricanes: learn, think, behave wisely. Snakes are an amazing and beautiful life form. Most of their activities benefit us, and they play an important role in the earth’s ecosystem. The world has many dangers, and we need to learn how to maneuver in it in a safe way. As you should with any wild animal, respect and avoid snakes.

Avoidance

Avoidance is what both the snake and we want to do. The best way for us to avoid them is to watch where we walk, don’t put our hands and feet into areas we haven’t first looked at or probed with a (long) stick, and give the snake a chance to avoid us. This works remarkably well. Considering the number of times we have all undoubtedly passed near a snake, there are remarkably few bites.

Proper woods attire—sturdy boots, long pants of dense material—will lessen or prevent the penetration of the fangs.

Snakes "hear" by feeling the vibrations in the earth made by approaching animals. We can exaggerate those effects by noisy approaches or thumping with a walking stick

Think about snakes—where are they likely to be? Snakes can’t regulate their own temperatures (the way birds and mammals can) so they seek places to be that will keep them the right temperature. During the heat of the day, they seek cool—under rocks, under bushes, out of direct sun. In the evening, when the air is cooling down, they may lie on top of sun-warmed rocks, or even lie on the street in quiet neighborhoods.

Keep yards free of brush piles and other features attractive to snakes and their prey, or at least be watchful when playing or working around snake attractions.

After such events as storms, flood, and fires, snakes and other animals are not where we expect them. Their lives have been disrupted, their dens flooded or washed away. Be more aware of the risk at these times, because the snakes may appear in unaccustomed places, and because we are often dealing with the debris that the snake has decided to make his emergency shelter.

If Bitten, No Heroics

Despite all the movies you’ve seen where people cut and suck snake bites, this is NOT recommended. There are snake bite pumps that might be helpful (the recommendations vary), but in our area, EMS will get to us far faster than we will be able to find our pump. Don’t apply a tourniquet, don’t use ice, don’t give pain medicines or alcohol.

Keep the bitten person calm (yeah, right), or at least keep him quiet and sitting or lying down if possible. Remove rings and anything that might be constricting as the body part swells. Call EMS. If possible, splint the limb. If possible and necessary, carry him to transportation. Unless you really know your snakes (that is, you are a herpetologist), go to the ER for any snakebite. Some bites (as those from the coral snake) don’t become symptomatic for many hours. Some small snakes are juveniles of the larger pit vipers (copperheads, rattlesnakes, and water moccasins), and they are more likely to give a venomous bite than the adults of their species. Some bites are just potentially dirty wounds that may have retained teeth and certainly have bacteria. If you can safely do so, try to notice enough about the snake to identify it. But don’t risk another bite.

In the ER, the overall status (breathing, heart function, kidney function, blood clotting ability) of the person who has been bitten is assessed and monitored. The bite itself is cleaned. A tetanus shot, if needed, is given. Anti-venin may be administered if severity warrants it, but there are significant risks of allergic reactions and serum sickness. Copperhead bites often don’t require use of anti-venin. Coral snake bites always do.

Snakes and we share the world. We do them more harm than they do us. We can learn to protect ourselves while reaping the benefits of having snakes in our environment.