Dr. M.J. Bazos, MD
In North America, snakebites
can be one of four types. The first type is from nonpoisonous snakes such as rat
snakes. These bites require only simple medical attention. The second type of
snakebite is from coral snakes. These snakes have a special type of venom that
affects the nervous system. Coral snakebite treatment requires hospitalization.
The third type of snakebite is from the pit vipers: rattlesnakes, copperheads,
and water moccasins. These snakes usually inject venom when they bite, and
emergency evaluation is required. The fourth type of snakebite is from imported
snakes from other areas. Although rare, they also require emergency
Living With Your
Your doctor can usually tell
from the appearance of the bite or the snake (if captured) if your bite was from
a poisonous or nonpoisonous snake. Fortunately, the pit vipers do not inject
venom (envenomate) in about 25% of bites. The signs of envenomation are intense
pain, swelling, and discoloration at the bite site. Swelling and pain that
extend toward the body from the bite site usually indicate higher degrees of
envenomation. Bites from the coral snake and some of the exotic snakes may have
no symptoms for the first few hours, and then sudden and rapid paralysis may
occur. If you are released without hospitalization, then your doctor is
confident that either the snake was nonpoisonous, or no venom was injected
care is the emphasis of treatment after discharge. The wound should be inspected
and cleaned with soap and water at least once a day. Old dressings that adhere
to the wound can be removed by soaking with water for several minutes. Hydrogen
peroxide can be used to remove clotted blood and debris. After cleansing, allow
the wound to dry, then apply an antibiotic ointment as suggested by your doctor.
Keep the wound covered with a dry, clean dressing. Change the dressing with each
cleansing and more often if it becomes wet or fluid soaks through. If another
bite occurs in the future, the following emergency treatments may be
• Remain calm and limit
movements. Keep activity to a
• Keep the bitten area still
and below the level of the heart.
Do not attempt to cut the bite or suck poison from the bite with your mouth.
Both can cause further injury and increase the risk of infection. Neither has
been shown to be effective.
emergency care as soon as possible.
Do not risk further bites by capturing the
• If there will be a delay
before treatment, a constriction band (such as a shoestring) placed near the
bite between the bite and the body may be helpful. It should be loose enough to
allow a finger to be introduced snugly under the
• Ice is of no proven benefit.
Heat should not be used.
• If there
is any question of the possibility of envenomation, emergency medical care must
• Make sure you have an
up-to-date tetanus shot.
• Clean and
inspect the wound daily. Report concerns
• Take all your antibiotics
as directed (if prescribed).
your follow-up appointment.
attempt to find the snake. More bites are likely to
• Don’t ignore your
symptoms. If in doubt, call and
• Don’t immerse your wound
in dirty water.
When to Call Your
• If you have increasing
pain, swelling, discoloration, or bleeding at the wound or in the wounded
• If you have fever,
shortness of breath, become sweaty, or feel
• If you have bleeding from the
nose or gums or easy bruising.
the wound appears infected (redness, swelling, pain, streaking, pus drains, bad