STORY BY“Snakes... Why’d it have to be snakes?”
Many of us relate to Indiana Jones’ reptilian revulsion in Raiders of the Lost Ark. After all, snakes are creepy, slithery, sneaky things – and they can bite.
But, heebie-jeebies aside, snakes have as much right to life as any creature, and our distrust, if not abhorrence, is a good thing. And it shouldn’t stop with snakes. We also must guard against mini-monster insects and the bats that eat them, especially as Texas’ weather heats up.
“You can get snake bites any time of year, but they’re cold-blooded creatures so they’re more active in warmer months,” says Richard N. Bradley, MD, associate professor of Emergency Medicine and chief of the Division of EMS and Disaster Medicine at The University of Texas Medical School at Houston.
The Texas Gulf Coast has two types of poisonous snakes: vipers, notably copperheads or rattlesnakes, and elapids, such as coral snakes.
Bradley has two words for you about such crawlies: avoid them.
“If you encounter any snakes, treat every one as potentially venomous,” he says. “I don’t expect most people to recognize a venomous snake from a non-venomous snake, and misidentifying them could be a fatal mistake.”
Even the bite from a non-venomous snake “can get infected and cause significant problems.” That’s why Bradley, who also is an attending physician at Memorial Hermann Hospital - Texas Medical Center and Lyndon B. Johnson General Hospital, encourages “anyone who gets a snake bite to go to an emergency department and get evaluated.”
Annually, about 8,000 people in the U.S. are bitten by snakes—not bad when you consider the nation’s population. “And many of those might have been avoided with proper safety techniques,” says emergency medicine physician Richard Bradley at the UT Medical School at Houston.
How do you protect yourself against the sobering threat of snake bites? For starters, stay sober, Bradley says. Many snake bites are associated with alcohol consumption. You’re careless, less aware of surroundings, and not to mention, slower when it comes to evading danger. “If you’re outdoors, go light on your use of alcohol.”
Beyond skipping sips, wear protective clothing.
“If you’re around trees, rocks or piles of wood, wear boots and long pants,” Bradley says. “And don‘t put your hands into rocks or woodpiles without checking first.”
Also be wary if you’re hiking on a trail, even through urban parks, such as Houston’s Memorial Park. “Harris, Brazoria and Montgomery counties are snake country,” Bradley says. “It‘s really surprising we don’t see more snakes here. I’ve found a viper in my driveway in suburbia.”
If you’re still unlucky enough to be bitten, Bradley’s first advice is to avoid a second bite. “Don’t put yourself at risk by trying to kill a snake,” he says. “Get away from it. Snakes can definitely bite more than once if they’re feeling threatened or provoked.”
They even can bite after they’re dead.
“If you do kill the snake, try not to destroy the head—it helps us identify the snake if you bring it with you to an ER. But remember: Biting is a reflex, and a decapitated snake can still bite for a long time after the snake is killed. So be very careful.”
After avoiding a second bite, your next response should be to wash out an open wound with soap and water. This reduces bacteria and infection. “Some snakes have more of an injection wound than a crushing wound, and for an injection wound, washing the skin won’t reduce that many bacteria,” Bradley says. “But any bacteria you can reduce will help lower the risk of a subsequent infection.”
Then, minimize body movement to reduce the spread of toxin systemically.
“If you’re bitten on the leg and are in a park, try to have someone carry you out,” Bradley says. “Exercise can push the venom through your body.”
But don’t bother raising or lowering an extremity. “There’s risk and benefits to both, so they cancel each other out,” Bradley says. “Mostly we want you to move as little as possible. And if there’s delay in transport to a hospital, splint the extremity to reduce movement.”
“You can put a splint on an extremity to immobilize it, but most other things we used to teach have been proven of no benefit and can be risky,” Bradley says. That means forget every cowboy movie you ever saw: no tourniquets, no constricting bands, no cutting, no sucking, no suction and no ice.
“Just go to an emergency department,” he says. “Don’t wait at home for complications to arise. And if you are delayed, the only first aid we suggest is to wash the wound in soap and water, if available, and to immobilize the extremity.” (Almost all snake bites are on extremities.)
“We draw blood right away, but mostly we watch people for awhile,” Bradley says. “We observe the bitten area to see if it starts to swell. We monitor blood to see if there’s a problem clotting. We watch to see if a person gets sick or has other complications.”
Even trained eyes may not readily discern the type of snake bite, but symptoms can be revealing. When the source is determined, anti-venom can be used, available in some (but not all) emergency rooms.
Vipers are our biggest problem, Bradley says. “They can cause a lot of tissue destruction to the extremity. It can take six to nine months to recover, and scars and tissue loss can be permanent.”
Now the good news: “I can’t remember a snake bite fatality in our area in the 10 years I’ve been here,” Bradley says.
Now the bad: “But it can happen.”
For some people, other creatures have a higher fright rating.
“Scorpion stings can be fatal,” Bradley says. “They have a toxin in their stinger that can be quite potent. And children, who are most likely to be stung, are at highest risk, since the dose is greater compared to their body weight.”
As with snake bites, “if anyone receives a scorpion sting, go to the emergency department. Don’t wait at home to see what happens.”
For scorpions, too, there’s anti-venom, derived from people or animals who were exposed to venom and developed antibodies to it. Without anti-venom, symptoms are treated as they occur. “If there’s respiratory failure, we put the person on a breathing machine. If their blood pressure drops low, we give them medication to support their vital signs,” Bradley says.
Though scorpions are common, their stings are not. After all, who’d get near them?
“Even if you’ve never seen a scorpion in real life, when you come to Texas and see one for the first time, there’s not a lot of chance you won’t recognize a scorpion,” Bradley says. “And you’ll certainly know if you’ve been stung, because scorpion stings are painful – immediately.”
The same goes for Texas’ vast armies of tiny, ill-tempered soldiers: fire ants.
“They’re the number one (bite) people come to the ER for,” Bradley says. “We see them a lot in kids, who often get stung while playing outside. They’re painful immediately and leave a mark on the skin that doesn’t go away for a week. Fire ants are the biggest problem we see.”
Spider bites are far less common.
“People often complain of a spider bite without having seen the spider, “Bradley says. “They may have a skin abscess which could have come up spontaneously.”
The only spiders that worry Bradley are the black widow and the brown recluse. Tarantulas? Forget it. They‘re not native to Texas, though they could be imported. And besides, they’re the enemy of your enemy: scorpions.
Perfectly at home in warm, wet climates are what Bradley calls “the world’s most dangerous insect: the mosquito. Worldwide it causes 300 million cases of malaria every year. Though we don’t have malaria in this area, there are still lots of diseases the deadly mosquito can carry.”
The top two in these parts are West Nile Virus (WNV) and St. Louis Encephalitis. WNV symptoms range from so-mild-you-miss-it to deadly. Both illnesses are viral (no curative treatment available) and can involve brain swelling and accompanying symptoms of fever, nausea and extreme lethargy.
Though the City of Houston sprays for mosquitoes, “that does not relieve people of the responsibility of applying some insecticide of their own, “Bradley says. “If mosquitoes are biting, don’t just sit there and take it. Get the appropriate insect repellent for you and the kids.”
Insect-eating bats aren’t venomous, either, yet bats can transmit disease.
“It’s extremely rare, but we have had deaths in Harris County caused by rabies from bat bites,” Bradley says. “They are the number one animal to spread rabies – not dogs, bats.”
Unlike fire ants or scorpions, a bat can bite without your knowledge.
“People say they woke up and there was a bat in their room, but have no memory of being bitten,” Bradley says. “The bites are painless and so innocuous at first that you don’t realize what’s happened. But a few years ago, a Harris County man woke up to find a bat in his bedroom, and within a couple of weeks he was dead from rabies.”
Nature’s rules are simple: creatures attack when they feel threatened.
“Most creatures, including snakes, don’t like to bite people,” Bradley says. “They bite because they’re scared and are defending themselves. They’re certainly not looking to us for a meal. If anything, they’re more afraid of us than we are of them.”
Comments do not necessarily reflect the opinion or approval of HealthLeader or The University of Texas Health Science Center at Houston.
D.L. in Illinois writes:
Date: July, 2008
At 5:00 am on May 6th, 2002 I was bitten by a brown brown recluse spider while lying in bed. The first day I went to the hospital they gave me aspirin and told me to go home to sleep the bite away. The next day I was rushed to the emergency room and told I was a fraction of time away from losing my leg or life. After nine days in the hospital they decided to remove the dead tissue. What I had left was a 12-inch diameter hole in my leg. After a scar rescission surgery last year I was able to reduce some of the plate size hole in my leg. The apartment I was in collected around 24 spiders which all proved to be brown recluse spiders. When I told the manager he laughed until he saw my leg and fainted. Even after all that it took the local Health Department to make him spray for bugs. Next time I see brown spiders strolling around my apartment I am packing my bags.
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Dr. Richard Bradley is associate professor of emergency medicine at the UT Medical School.
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Packing Bag Lunches Safely
If you pack lunches for your child to take to school, be careful that you do not accidentally expose them to foodborne illness.
Bagged lunches, especially those containing perishable foods, need to be packed and handled properly in order to keep the food safe. In general, perishable foods should not be left at room temperature for more than two hours. If left out too long, the temperature of the food can enter the danger zone where bacteria grow most rapidly, which is between 40 and 140 degrees Fahrenheit.
Below are some tips to help families pack bagged lunches safely:
Before eating lunch or snacks at school, make sure your child washes his or her hands with soap and warm water for at least 20 seconds. If your child's school does not have a handwashing program in place, encourage them to adopt a such a program, as handwashing is one of the best ways kids and parents can protect health and stop the spread of germs.
