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The Weasel
09-04-2002, 14:37
Although I know some people will argue anything, frankly, some things are too risky to debate, and the "snake bite kit" is one of them. A recent New England Journal of Medicine article (excerpt below, and link to longer description also below; full text available on line for $10 or from your local library) makes that clear. If you're not sure what the NEJM is, it is the foremost medical journal in the United States, and probably tied with The Lancet (U.K.) for best in the world; it is peer-reviewed, and damned good. I have further comments after the excerpt, which is:


Don't Suck a Snakebite
Experts Dispel Snakebite Remedy Myths
By Jennifer Warner

Aug. 2, 2002 -- It's a scene played out in countless cowboy movies and survival shows: a hapless snakebite victim is rescued by a quick-thinking hero who sucks out the poison and spits it onto the ground. But experts say that approach to snakebite treatment is based far more on fiction than fact.

"The evidence suggests that cutting and sucking, or applying a tourniquet or ice does nothing to help the victim," says Robert A. Barish, MD, an emergency room physician and associate dean for clinical affairs at the University of Maryland School of Medicine, in a news release.

"Although these outdated measures are still widely accepted by the general public, they may do more harm than good by delaying prompt medical care, contaminating the wound or by damaging nerves and blood vessels," says Barish.

Barish and colleagues at the Rocky Mountain Poison Center in Denver reviewed the research on snakebites and their treatment in an article published in the Aug. 1 issue of The New England Journal of Medicine.

http://webmd.lycos.com/content/article/1689.53765

See also: http://www.snakebitenews.com/index.html
OK folks, I don't give a damn what Mr. Cutter and his cute little kit say, answer these question, FAST: How far below the skin on wrists/arms and feet/ankles (the places most often bitten) are major VEINS? How far below the skin are major NERVES? Half inch? Inch? More?

Answer: Often less than 1/8". And you're going to take a razor blade and start cutting? Not knowing the coagulability of the blood of the victim? Do you realize that medical students take MONTHS in Gross Anatomy classes dissecting bodies to learn where nerves and veins are...although they are slightly different for each person? Even your own GP or internist probably couldn't make a safe incision in your wrist or ankle, and that's the reason she or he WOULDN'T.

Yeah, I know we all wanna play doctor, and we all wanna get a medal and our picture in the paper for being a hero. But I'm not kidding here, folks: If you open a vein or paralyze someone's right hand or leave their lower leg in excruciating pain for the rest of their life NEEDLESSLY, you ain't gonna get a medal. MAYBE you won't get a lawsuit, but you sure aren't gonna get a medal.

And oh, yeah...the great "tourniquet" debate, too, should end sometime yesterday: Snake venom often causes severe coagulation - clotting - of blood, and a tourniquet (which stops or slows blood flow in the veins) can also increase clotting. Yeah. Way cool. Then if a clot gets past the tourniquet, it'll be nice and huge, thereby insuring when it makes the fast track the last four feet or so to the lungs, heart, or brain the resulting heart attack or stroke will kill even faster! And then the poor damn snake gets the blame? Think it through, folks.

What is the best - really, the only! - treatment? Try to keep the bitten location below the heart, so that venom spreads more slowly. Get medical attention as quickly as possible. That's it. All she wrote about treatment. End of paragraph, story, and issue.

Why am I on a rant here? Because I get very, very upset when really, really, really bad medical advice continues as "urban legend" or myth about safe health practices and other ones that are demonstrably dangerous. If someone told you to pull the head straight of someone with a broken neck so that the bone could set, would you really do it? Nahhhh...that's stupid! What if someone gets a "broken neck straightener" into the Campmor catalog? You gonna buy it? Oh sure...if it's sold to the public, it MUST be safe! (No one, by the way, regulates "snake bite kits". How about if some damn fool you'll never see in person puts it on a web page? Half the world will believe it, because EVERYTHING on the Web is true, isn't it?

Friends, I'll go with the top medical journal around, and EVERY M.D. that you can find: SNAKE BITE KITS ARE DANGEROUS AND INCAPABLE OF ANY BENEFIT. THROW THEM OUT.

The Weasel


"Well a promise made, is a debt unpaid, and the Trail has its own stern code." -- Robert Service

dallan
09-23-2002, 06:16
I was just wondering if the little suction cup ($9) vial I bought then is useless in other people's opinion? I bought it at a hiking store and the guy (who gave me a 10% discount on $100 order, so I don't think he was out to rip me off) told me he recommends it because they say it gets 85% of the venom out if done promptly, what do you all think?
Also, planning to hike the AT in winter (oct 2 on) going south, please, PLEASE, PPPLLLEEEAAASSSEEE send any suggestions about this hike to me, I'm going because I promised I would go with a friend, we have spent nearly $2000 on supplies and he's hiked out west a decent amount, so we're doing it.. would love to hear advice...
thanks and God bless,
dallan

Peaks
09-23-2002, 07:39
First, you will see very few poisonous snakes. Then, most of them will just lie there and not give a hoot, unless you poke them. All the snakes I saw were not aggressive at all.

So, bottom line, there is very little need to carry anything for snake bites.

Probably the only people who benefit from snake bite kits is the outfitters who sell them.

Hikehead
09-23-2002, 08:07
The ATC has not had a report of anyone being biten by a poisonous snake ON THE AT in the last decade.

That's what the ALDHA says.

Read it here.

http://www.aldha.org/advice.htm

The Weasel
09-25-2002, 03:54
Yes, the suction cup is useless. No, he didn't "rip you off" because the "conventional wisdom" still is that it's useful. But "conventional wisdom" is wrong a lot. Such as it is this time. The suction cup is worthless. Before the argument rages, anew, go read the link I provided earlier in this thread.

saimyoji
12-08-2004, 00:01
Snake bite kits, cutting and sucking will ALWAYS do more harm than good. If you don't do serious damage to your buddy, you may get a dose of the venom yourself if you have a cold sore, cut in your mouth.

BTW: There are NO poisonous snakes. Poisonous is often mistaken for Venomous. There is no snake whose meat contains any toxins, they can all be eaten. Please read: perfect survival food, if you can catch one.

Thems good eatin

Happy
12-08-2004, 00:37
Worthless!

grandview
12-08-2004, 01:10
Worthless!
i'll be suctioning the heck out of myself if i ever get bit by a rattler.

Happy
12-08-2004, 01:39
i'll be suctioning the heck out of myself if i ever get bit by a rattler.

You have better odds of being struck by lighting TWICE on the same mountain bald and even if you did it is a 50 per cent chance of a dry bite!

Better to remain calm and take off to the nearest outing to a road to go to a hospital. Don't kill or take the snake with you...not needed!

The more panic the worse...chances of death are remotely slim!

Mountain Dew
12-08-2004, 02:21
How no A.T. hikers have been bitten in a decade is a small miracle in my opinion. There are tons of poisenous snakes on certain parts of the trail.

Youngblood
12-08-2004, 07:42
This is amazing! This is an older post that has been brought back to life. It is also so full of *****. The snakebite kits do not say to cut and apply suction, they say to apply suction without cutting... there is a huge difference. In fact on reading one of the links that the Weasel gave, here is what it says in the FAQ section:

"A: Yes. If you cannot seek attention immediately, many health-care professionals embrace just a few basic first-aid techniques. According to the American Red Cross, these steps should be taken: wash the bite with soap and water and immobilize the bitten area and keep it lower than the heart. Some medical professionals, along with the American Red Cross, cautiously recommend two other measures: if a victim is unable to reach medical care within 30 minutes, a bandage, wrapped two to four inches above the bite, may help slow venom. The bandage should not cut off blood flow from a vein or artery. A good rule of thumb is to make the band loose enough that a finger can slip under it. A suction device may be placed over the bite to help draw venom out of the wound without making cuts. Suction instruments often are included in commercial snakebite kits."

Of course time is extremely important and the number I recall from Doc Foggerty's(sp?) lecture (and the info in the snake bite kit) is something like this(?): if you can get the suction device applied within three minutes, then you might be able to withdraw up to 50% of the venom.

The chances of snakebites vary and I figure that they go up if you are on brushed over trail or bushwack to find stealth campsites, like hammockers do. I carried one when I first started backpacking (didn't on my thru-hike) but decided I didn't need one after I got more experience on well maintained trails... until I started hammocking. Then it dawned on me that I was often walking in brush where I couldn't see what I was stepping on and that I was often by myself and/or many miles and hours (maybe days) from assistance... so I now carry one where I can get to it quickly, and hope it is wasted weight.

Youngblood

orangebug
12-08-2004, 08:19
The suction device that is recommended is the Sawyer Extractor. It can develop suction that actually does something modestly useful. It is not the rupper nipple of the usual snake bite kit.

Snake bite kits are pretty useless. The infrequency of snake bites and the lack of fatalities is not surprising. The most common circumstance of a snake bite involves alcohol and testosterone poisoning of Darwin Prize contestants. "Hey, lookie this" is the common phrase just before the venom is injected.

Humans are not on snakes' menus. Snakes aren't seeking revenge, only food or protection. If you raise the usual hiker racket, watch your feet in the brush, avoid stiking your hands under rocks and into snake dens, you will be very lucky if you even see a snake.

The advice remains to stay calm, immobilize the extremity if possible, a light band (if any) to reduce venous and lymph return, and evacuation to an ER ASAP. 50% of bites are "dry" but "wet" ones can develop symptoms hours after the bite.

Youngblood
12-08-2004, 08:46
The suction device that is recommended is the Sawyer Extractor. It can develop suction that actually does something modestly useful. It is not the rupper nipple of the usual snake bite kit.

Snake bite kits are pretty useless. The infrequency of snake bites and the lack of fatalities is not surprising. The most common circumstance of a snake bite involves alcohol and testosterone poisoning of Darwin Prize contestants. "Hey, lookie this" is the common phrase just before the venom is injected.

Humans are not on snakes' menus. Snakes aren't seeking revenge, only food or protection. If you raise the usual hiker racket, watch your feet in the brush, avoid stiking your hands under rocks and into snake dens, you will be very lucky if you even see a snake.

The advice remains to stay calm, immobilize the extremity if possible, a light band (if any) to reduce venous and lymph return, and evacuation to an ER ASAP. 50% of bites are "dry" but "wet" ones can develop symptoms hours after the bite.

Orangebug,

I agree with what you say. I have seen a few venomous snakes on trails and was probably 'seen by' a great deal more. I recall one time about a year ago where about 5 of us were taking a break, enjoying the view and a big rattlesnake slithered out on the trail about 6 feet from us in the direction we were heading. It was neat as we got to see a beautiful snake from a save distance and one of them was an ole country boy who knew how to safely move the thing off of the very narrow ridge trail so we could get by, but you know what? Several of them wanted to see my snake bite kit and see how to apply suction the next time we stopped to take a break. You are a hammocker and sometimes walk off the trail to find a site, aren't you... think you might have wanted to take a look at it if you where there?

I'm not saying that everyone needs a snakebite kit... that is a personal decision. What I am saying is that some of the earlier post on this thread, and especially the first one, is VERY INCORRECT about the potential usefulness of snakebite kits and I think it should be corrected. For reference, this is the last line of the Weasel's post:

"Friends, I'll go with the top medical journal around, and EVERY M.D. that you can find: SNAKE BITE KITS ARE DANGEROUS AND INCAPABLE OF ANY BENEFIT. THROW THEM OUT. ...The Weasel"

Youngblood
12-08-2004, 09:47
I never posted the photos of the Rattle Snake since it wasn't actually on the AT, but they seem appropriate now. This should link to them:

http://www.whiteblaze.net/gallery/showphoto.php/photo/5827/sort/1/size/medium/cat/550/page/

http://www.whiteblaze.net/gallery/showphoto.php/photo/5826/sort/1/size/medium/cat/550/page/

These are pretty good photos of what you actually see. Snakes are experts at not being seen and with the right background you will probably not even see them unless they move. Brushy trails or bushwacking is different than well groomed trails because of that. I was using a small digital camera with a x3 telephoto lense, so I am not as close as you may think. The snake came on the trail as about 5 of us were taking a short break to enjoy the vista on a narrow ridge trail and actually entered the trail while we were still and was sort of heading in our direction. When I approached to get a closer photo, the snake held its ground and assumed its strike postion. One of my hiking partners used a stick (or hiking pole?) to remove the snake off the trail without it or us being injured.

Youngblood

Happy
12-08-2004, 11:43
Most Doctors agree that you do more harm with the snakebite kit attempt than good...most people would do incisiions or not own the proper kit.

The ONLY recommended kit is the Sawyer Extractor which could remove UP TO 30% of the venom if used within 3 minutes of the bite AND performed for 30 minutes. This is stated in "Wilderness and Travel Medicine" by Eric A. Weiss, M.D.

My sentiments are that if possession of such a kit gives you peace of mind then by all means carry the proper one and learn the correct way to use it.

My days of bushwhacking in areas that would be VERY remote are over, and I enjoy the AT and side and loop trails now that are closer to roads, etc.

I have seen very large timber rattlers on the trail (sunning and would not move) and realize that being bitten is possible, however remaining calm is easily said but would be my first thing to try and overcome.

I am not sure that within 3 minutes I could distance myself from the snake, calm down, retreive the extractor put it own the bite and start extracting.

Then extract for 30 minutes to remove 15-30% of the venom...not sure how much this improves your chances, especially if it is the 50% of the time dry bite. Bushwhacting remotely, I would certainly try.

On the AT, I would probably use this 33 minutes to try and calm myself down and then look at my maps and put serious thought into my best and fastest escape route and haul my hiker butt out of there! :D

HikeLite
12-08-2004, 11:45
http://www.emedicinehealth.com/articles/27066-3.asp

Snakebite Treatment

Wash the snakebite with soap and water and remove all jewelry.

Suction using an extractor device WITHOUT incising the wound should be applied if less than 15 minutes has elapsed from the initial bite and the victim is more than 1 hour from medical attention.

If less than 30 minutes have passed, apply a constricting band above the bite. It should be tight enough to slow circulation but not stop pulses. Use the pressure immobilization technique.

Immobilize the limb below the heart.

Cool the limb for pain control, but do not apply ice directly to the wound.

Give 100% oxygen.

CPR may be necessary.

Bolo
12-08-2004, 12:00
How no A.T. hikers have been bitten in a decade is a small miracle in my opinion. There are tones of poisenous snakes on certain parts of the trail.Singing snakes on the AT? Where?

Would it be advised to treat all snakes as poisonous and seek medical attention? Especially if you cannot identify?

orangebug
12-08-2004, 12:38
Only seek medical attention if a venomous snake bites you. :rolleyes:

I would expect that you would recognize the very triangular shape of a pit viper - with only rattlesnakes and copperheads affecting us onthe AT. You might get another non-venomous snake to bite you, but you would have to do something pretty extreme such as picking it up and providing the opportunity.

Once you were bitten, I'd expect the snake to retreat and get away from you as a defensive action. You would experience pain immediately, although some report no major pain for hours. Something about pain and fear typically focuses folks on dealing with the problem at hand, although some will panic and make matters worse. If you decide to carry a Sawyer Extractor, it makes sense to learn how it works before the need arises. Training yourself up on your gear is always a good idea before heading out.

Bolo
12-08-2004, 13:13
Thanks, Dr. OB. Think I need to brush up on my snake ID.

Spurrier's the man. GO COCKS!

orangebug
12-08-2004, 13:18
Spurrier the whiner?

Tigers will shred another Gamecock coach. The bigger the legend, the sweeter the collapse. :bse

neo
12-08-2004, 13:54
i carried one when i was a boyscout over 30 years ago,they can cause more harm than good,i dont carry one:jump

Youngblood
12-08-2004, 15:16
i carried one when i was a boyscout over 30 years ago,they can cause more harm than good,i dont carry one:jump

Neo,

Do you realize there is a difference between the rubber suction cup snake bite kit, http://www.scoutgear.com/cg7925.html , and the Sawyer Extractor, http://www.southernsierrabsa.org/adventure/sawyer.html . The Sawyer Extractor is the one that is recommended, it pulls quite a bit of suction and has 3 or 4 different quick connect nozzles to better fit the wound area.

Youngblood

orangebug
12-08-2004, 15:21
The Sawyer Extractor is designed primarily for insect stings and reactions, but is used in snake bites. It is fairly bulky. It is not a proven treatment, but does nothing to make matters worse. It takes little time to apply and allows evacuation of the person promptly to definitive care.

sherrill
12-08-2004, 15:24
I've been bitten twice, by a timber rattler and a copperhead. Both were "dry" bites.

The rattler bit me while rappelling near Table Rock in Linville Gorge, NC. I literally landed on the snake.

The copperhead got me while I was weedeating near my birdfeeders. I simply didn't see him waiting on the ground to catch a bird, and stepped on him. You would think that the weedeater's noise would have scared him off, I guess he was pretty hungry.

In any snakebite situation, it's important to get away from the snake as fast as possible. In fact, the rattler struck at me again but missed. It's also important to try to wash out the wound as fast as possible to clear any bacteria the fangs may also inject. Stay calm, get to an ER as quickly as you can, and you will be ok. If it appears that you won't get medical attention within the hour, a bandage can be applied a couple of inches above the bite, but make sure it's not too tight. You should be able to slip your finger under it. At this point it's debatable whether or not a suction device does any good. At any rate, keep the bite level or slightly below your heart.

It's important to seek medical care as they can monitor you to make sure you need antivenin. Fortunately for me it was just painful puncture wounds and I lost no tissue.

I am the exception, not the rule. Most snakes would prefer not to bite you, I just happened to be in the wrong place/wrong time. Keep aware of your surroundings (like me near those feeders) and the snakes, especially rattlers, will let you know if you're getting too close.

max patch
12-08-2004, 15:28
I carried the Sawyer Extractor on my thru. I don't know if it helps or not and I really hope I never have to find out, but I carried it because if I had been bitten I would rather have it available for use than to have nothing at all. Certainly doesn't cause any harm.

grrickar
12-08-2004, 21:25
Should we start a poll? Sawyer pump or not? I bought one for a section hike, but ended up not carrying it. My hike was the first week in Oct. and I only saw one snake. It slithered off the trail so quickly I couldn't tell what kind it was.

My take is since in many cases you are nowhere near civilization, it would not hurt to apply the Sawyer, then put on a loose compression bandage (not a tournequet).

A guide I read said remove jewelry and tight fitting clothing since there may be swelling which will make it difficult to remove later. It also suggested bandaging just above the bite area with a bandage about as tight as one would expect on an ankle wrap.

Magic City
12-09-2004, 10:23
I get very, very upset when really, really, really bad medical advice continues as "urban legend" or myth about safe health practices and other ones that are demonstrably dangerous.
While I agree with our overall point, this does not qualify as an urban legend. Rather, this is a change in the accepted medical advice, as happens often in the medical field.

I was teaching EMTs and paramedics when this change came about, so I know this. Prior to this change, variations of these kits were carried on ambulances and these procedures were accepted emergency medical practice.

I still have some of the books, and it's interesting to look back and realize that some of the things that seem so ridiculous now were not questioned by most of the people in the emergency medical field then.

The evolution of medical standards is a good thing, as it demonstrates our ability to learn from mistakes, to develop new and better ideas, and to make use of new technology.

But it's not fair to refer to what was done before as an urban legend.

Happy
12-10-2004, 14:02
http://www.emedicinehealth.com/articles/10707-5.asp

Youngblood
12-10-2004, 17:42
http://www.emedicinehealth.com/articles/10707-5.asp

This contradicts that reference:
http://www.snakebitenews.com/html/faq.html .

Question: If you and I were hiking together, you were bitten by a rattle snake and we were a day a way from a paved road; would you want me to use my Saywer Extractor on you or just leave it in my pack so that it wouldn't cause more harm? Before you answer that I have another question for you: have you seen pictures of the tissue damage done to survivors of a serious rattle snake bite?

Footslogger
12-10-2004, 18:07
Lots has changed since I got my original paramedical training in 1972 but one thing remains the same. As a first responder/caregiver you don't want to make things worse ...in other words, above all else do no further harm. Another appropriate thing to remember is that it's not smart to do something you've never been taught to do.

I'm no longer a practicing paramedic but I still let the above guide my behavior in most emergency situations.

Not exactly the same scenario ...but think about cardiac arrest for a moment. Lots of people go through CPR training every year and the vast majority of them never apply that skill. Sometimes there is so much attention paid to the number of compressions versus the number of breaths that the average student concludes that they're doing it "wrong". The concept there is to introduce oxygen into the system and cause the heart to pump blood outward to the brain and the rest of the body. Personally, if I was in full cardiac arrest I'd rather have someone attempt to revive me, even if they got the breaths to compression ratios wrong.

Not too sure where I was headed with that but I do have a thought about "The Extractor" and other such devices. If you're gonna carry one then read all you can about it and practice using it ...say on an orange or something. Case in point ...worst thing I've ever seen was a person carrying an "EpiPen" who didn't know how to use it.

'Slogger
AT 2003

Happy
12-10-2004, 19:51
This contradicts that reference:
http://www.snakebitenews.com/html/faq.html .

Question: If you and I were hiking together, you were bitten by a rattle snake and we were a day a way from a paved road; would you want me to use my Saywer Extractor on you or just leave it in my pack so that it wouldn't cause more harm? Before you answer that I have another question for you: have you seen pictures of the tissue damage done to survivors of a serious rattle snake bite?

In my previous post I stated that if I was in a remote bushwhacking situation I would certainly try the extractor for peace of mind, and hope it will help save my life!

I have not seen tissue damage done to survivors of a rattle snake bite...and I am not a doctor, but have done a lot of reading on this subject to be prepared in case it happens!

If I am on the AT, or similar trail and think I can reach a hospital within 8-12 hours, I would do as I previously posted and try to be calm, read my maps and provide serious thought to my best exit, and haul my hiker butt in fast gear to get to the ER. :D

Youngblood
12-10-2004, 22:09
In my previous post I stated that if I was in a remote bushwhacking situation I would certainly try the extractor for peace of mind, and hope it will help save my life!

I have not seen tissue damage done to survivors of a rattle snake bite...and I am not a doctor, but have done a lot of reading on this subject to be prepared in case it happens!

If I am on the AT, or similar trail and think I can reach a hospital within 8-12 hours, I would do as I previously posted and try to be calm, read my maps and provide serious thought to my best exit, and haul my hiker butt in fast gear to get to the ER. :D

It's a tough issue isn't it. One I don't wish on anyone. I tried to find photos on the web but didn't come across what I remember seeing. Maybe I saw them on a TV program? Anyway, I think that surviving is one thing and surviving without serious permanent tissue damage is something else.

When I hiked the AT I didn't worry about it too much and didn't take the Sawyer Extractor. It was only after I hiked more isolated trails solo and started hammock camping that I decided to take the extractor again. I put it in the front mesh pocket of my backpack so that I can get to it quickly. The more isolated trails are often more brushed over and hammock camping sites often require trudging off trail to find desirable sites. That got me thinking that I was increasing my chances of having an undesired snake encounter, so I started packing the extractor again. It makes me feel better, so that is worth something.

Youngblood

SGT Rock
12-10-2004, 22:26
Question: If you and I were hiking together, you were bitten by a rattle snake and we were a day a way from a paved road; would you want me to use my Saywer Extractor on you or just leave it in my pack so that it wouldn't cause more harm? Before you answer that I have another question for you: have you seen pictures of the tissue damage done to survivors of a serious rattle snake bite?

Please leave it in your pack if I am with you.

NotYet
12-10-2004, 23:39
In the last few WFR courses and re-certification courses I've taken, the Sawyer Extractor was mentioned as a good option. Of course if you're bit by a pit viper close to the road and close to definitive care, it would probably be best to just get to the doctor quickly to get checked out.

However, in the back woods you are usually at least several hours from treatment; so if you have a Sawyer Extractor it could be of help. First, it won't cause further damage (there is NO cutting involved, and you DON'T put your mouth anywhere near the pucture wound...both "old school techniques" are extremely dangerous! It's the devise itself that creates a light suction). Second, although you probably weren't envenomated, you won't know whether you have been or not. But if you have been, using the Extractor could help remove some of the venom which might minimize some of the damage that can occur. Finally, one of the most important things to do in case of a poisonous snakebite is to help the patient maintain calm, thus reducing the heart rate. It would seem to me that using the Extractor would help calm down the patient because the patient will witness something "official-looking" being done.

It's not that I think everyone should carry one of these items. I don't usually have mine with me when I'm on a personal hike, but I do carry it when I'm with hiking with clients during "snake season". I can't imagine viewing this thing as dangerous. If you want to carry one, carry one. If you're far from help and are bit by a pit viper, stay calm, clean the puncture wound, lightly wrap and keep the bite below the heart...if you have a Sawyer Extractor, use it.

P.S. I've heard that the Sawyer Extractor is the only type of suction devise that is recommended for use in the field.

grrickar
12-11-2004, 15:52
Short of giving yourself a massive 'hickey' from using a Sawyer pump, how exactly is one going to 'damage tissue' with one? I've seen venomous snakebites, and the tissue damage from the venom far exceeds anything a Sawyer pump could 'inflict'.

orangebug
12-11-2004, 16:42
Yup, I was wondering the same thing.

OTH,, if you are unfamiliar with the Sawyer Extractor and choose to wait until after a bite to learn it's use, then you might do better just walking on to the closest paved road and read the instructions while you wait at the ER.

Jack Tarlin
12-11-2004, 16:53
Very interesting thread. A few thoughts: Someone posted that they were surprised that a nearby copperhead hadn't been scared off by the noise of the weed-whacker he was using. Actually, all snakes are profoundly deaf; the guy could've been playing a trombone and the snake wouldn't have heard it.

Snakes' bellies are extremely sensitive and they can pick up minute vibrations from the ground, so they generally do know when a hiker is around, or is approaching. But this doesn't necessarily mean that they're going to get out of the way by the time you get close to them. Very often, they'll be right on, or just beside the Trail. Never take for granted that they know you're coming and are consequently getting out of your way.

And speaking of noise, a tip to folks who'll be hiking next year: I noticed this year that thanks to better and cheaper technology, more and more hikers seem to be packing and using music systems that involve headphones. In that this renders one incapable of hearing much other than one's favorite songs, this should be done with a good ammount of caution in the south, and with extreme caution in central Pennsylvania. Timber rattlers don't always warn you of their presence, but oftentimes, they do, and when another animal (or human for that matter) does not respond to their "warning" they view this as potentially agressive behavior, i.e., they're probably likelier to strike.

So word to the wise: If you're planning to listen to tunes while hiking, do so with a little common sense. Mr. Rattler really doesn't want to bite you, and that's one of the reasons he usually gives out a warning. If you ignore the warning, mainly because you can't hear it----well, he's goona do what he has to.

Happy
12-12-2004, 02:58
Short of giving yourself a massive 'hickey' from using a Sawyer pump, how exactly is one going to 'damage tissue' with one? I've seen venomous snakebites, and the tissue damage from the venom far exceeds anything a Sawyer pump could 'inflict'.

Which kind of bites have you had access to and what did you witness?
Please detail, as they are rare and most of us will go a lifetime without the details you have already witnessed TWICE OR MORE!

Did you bother to read the reference I posted on this subject...if so please elaborate, so we can all be enlighted! ;) ;) :D

HikeLite
12-12-2004, 10:21
Happy,

It is interesting to see that your link and my link differ in their recommendations about using the suction. The link I gave above from the same website is for snakebite in a wilderness situation (delayed help).

orangebug
12-12-2004, 11:14
I must be missing something. Both Happy and Hikelite are citing the same eMedicine website, which is excellent but deals with snakes of all varieties worldwide.

Youngblood's article is also excellent, adding the good advice to maintain suction, compression, immobilization or Ace bandage until arrival at the ER.

These all look consistent.

In other words, quickly make the decision what you can treat immediately after the snake bite and begin evacuation within the next 10-15 minutes. Once you begin a treatment, don's screw with it. On the AT, we are more concerned with the edema, bruising, pain and local tissue injury than with hemolysis or neurotoxicities. Amputations may result, but death is unlikely. There is nothing beyond the first 10 minutes that a hiker can do to change this prognosis, unless they start doing stupid things. Actually, it may be "more stupid things" if the bite started with a "hey lookie at this" event.

grrickar
12-12-2004, 13:05
Which kind of bites have you had access to and what did you witness?
Please detail, as they are rare and most of us will go a lifetime without the details you have already witnessed TWICE OR MORE!

Did you bother to read the reference I posted on this subject...if so please elaborate, so we can all be enlighted! ;) ;) :D
I never witnessed any in person, just some on the wonderful world of TV known as the Discovery Channel. I think the show is called Venom ER, and it shows some ugly signs of tissue damage from different snakebites. I never said I witnessed them firsthand.

Yeah, I read the link and found this quote, which still does not describe how it increases tissue damage:
"While applying mechanical suction (such as with a Sawyer Extractor) has been recommended by many authorities in the past, it is highly unlikely that it will remove any significant amount of venom, and it is possible that suction could actually increase local tissue damage. "
If you do a Google search on snake bite, you will find numerous articles - many of which contradict one another. I'm not taking sides here, but I fail to see how a Sawyer Pump could make matters worse.

grrickar
12-12-2004, 13:24
One thing I would like to know is in a wilderness situation, the victim has to be moved off the trail and to the nearest town, which may not be very closeby. Unless there are several hikers to help carry the victim, the victim may have to hike out on their own, which means their heartrate will be elevated which is not a good thing. That is one reason I feel that carrying a Sawyer pump could at least get some of the venom out if used immediately after the bite.

Lots of websites out there, most of them contradicting another. For example, some say to apply ice to the site, while others do not.

Here is a link to rattlesnake treatment, from the UCSD website:
http://www-surgery.ucsd.edu/ent/DAVIDSON/Snake/Crotalus.htm

Step 2 reads: "Identify the bite site, looking for fang marks, and apply the Sawyer Pump extractor with the largest cup possible over the bite site. If there are two or more fang marks noted on the limb, apply the pump extractor over at least one fang mark. If more than one pump extractor is available, they may be applied to the additional fang marks."

For those who think using the pump will delay moving the person and will put them at further risk, I found that in cases where the person will have to walk out on their own most articles stated to lie the victim down and calm them first. It makes sense to me since the victim will likely be excited by the bite, and their heart will be racing.

While calming the patient down, personally I would do the following:
Reassure the patient. Have them remove jewelry and boot if it was a leg bite (swelling may complicate removal later)
Wash the wound with soap and water
Use the Sawyer Pump
Ace/constrictor bandage the site area (not a tourniquet)
Get the patient up and moving

Anyone attend a NOLS first aid class lately? What is their current advice for snakebite treatment?

grrickar
12-12-2004, 13:40
I guess I answered my own question:

http://www.nols.edu/wmi/articles/archive/snakes.shtml

"Around the world, snake venom often varies greatly depending on the species, and specific treatment may vary. Most patients will benefit from these guidelines which have been developed especially for North American pit viper envenomation: Calm and reassure the patient. Keep the patient physically at rest with the bitten extremity immobilized and kept lower than the heart. Remove rings, watches, or anything else that might reduce the circulation if swelling occurs. Wash the wound. Measure the circumference of the extremity at the site of the bite and at a couple of sites between the bite and the heart, and monitor swelling. Evacuate the patient by carrying, or going for help to carry, or, if the patient is stable, by slow walking. Do NOT cut and suck. Mechanical suction (NOT oral suction) may be valuable if you get there in the first five minutes. Suction should be applied for 30 minutes via the Sawyer Extractor. Do NOT give painkillers unless the patient is very stable, showing no signs of getting worse. Do NOT apply ice or immerse the wound in cold water. Do NOT apply a tourniquet. Do NOT give alcohol to drink. Do NOT electrically shock the patient."

One other interesting fact I found in the article: "Arizona is the most likely place to die of a snakebite, with Florida, Georgia, Texas, and Alabama filling out the top five."

orangebug
12-12-2004, 13:56
Arizona has a type of rattler that also carries a neurotoxin. It is also far more empty than our east.

I would not remove a boot assuming a leg bite, unless we know there is foot jewelry, anklets and the like. Unless I am with a team of 3 or more hikers to help the evacuation, I'd like to use the victim to aid the trip to the trailhead. I would rinse and wash the bite as best as possible, mainly to aid observation of broken fangs for removal, and to allow an easier attachment of the Sawyer Extractor, if I had one.

BTW, the eMedicine site has some photos of rattlesnake and copperhead injuries, which aren't terribly graphic or lunch-losing. Occasionally, the cure of antitoxin can be just as bad, as serum sickness can occur for folks sensitized to horse serum. That can make for a nasty ICU photograph.

illininagel
12-12-2004, 15:56
The thing that concerns me about treating snake bites is the complication of hikers that are hiking alone.

What should one do if they are bit by a snake while hiking alone? Is it a good idea to start walking for help, or does this just elevate the heart rate and make things worse? Or, is it best to wait for help if you are on a well travelled trail?

SGT Rock
12-12-2004, 15:59
Bandage the wound. Look at the map, find the shortest route out possible. Then walk calmly out while trying to keep the wound below the level of the heart. Most likely this will be on an arm or leg. If possible, like on the leg, then immobilize it. If you run accross someone else, let them know so they can provide help. Do not go off trail to bushwack.

climb-on
12-12-2004, 22:11
snake bites are a bummer did that one 20 years ago

Mountain Dew
12-13-2004, 02:55
Bolo.... Ever notice how the E on the keyboard is really close to the S ? This is likely the cause of me using the word "tones" when I meant to use the word "tons". Care to explain this comment is all caps ? Bolo, " GO COCKS" --- :banana

Magic City
12-13-2004, 13:18
The treatment of snakebite has always been an argument. When I was teaching EMTs and paramedics, from the four available textbooks, you'd generally find at least three different standards for treating snakebite. Even when the standards changed, they'd differ from one book to another. Personally, I'd probably not carry a Sawyer pump because I think my chances of getting bit are low, but I can't see any reason to object to its use.

grrickar
12-13-2004, 16:07
I honestly cannot recall where I read this but it was many years back - a guide I read on snakebites said to kill the snake and bring it to the hospital for identification. While I know that ID'ing the snake is important so they know what type of anti-venin, whoever thought it was a good idea to tell the person bitten to put themselves at risk of being bitten again by trying to kill the snake was an idiot.

SGT Rock
12-13-2004, 18:24
I read a manual that siad to kill the snake, it might not help, but at least you would feel better.

Mountain Dew
12-14-2004, 02:04
snake bite kits make me laugh. I'd rather carry something more useful .... like some lead weights.

Youngblood
12-14-2004, 09:11
I honestly cannot recall where I read this but it was many years back - a guide I read on snakebites said to kill the snake and bring it to the hospital for identification. While I know that ID'ing the snake is important so they know what type of anti-venin, whoever thought it was a good idea to tell the person bitten to put themselves at risk of being bitten again by trying to kill the snake was an idiot.

Don't know this for a fact, but that advise might have been for hunters or other folks toting a firearm who would be able to just shoot the snake. Or maybe lumberjacks who could use something to safely kill it. I know we sometimes forget, but the great outdoors doesn't, or at least it hasn't always, revolve around us defenseless hikers. :)

Youngblood

rocket04
12-14-2004, 11:04
A little off topic on this, but I can't help myself. I met this thru-hiker this year that said he ran into a rattler in the middle of the trail that just woudn't move. He stomped his feet, it wouldn't leave. He poked it with his pole, it wouldn't leave. He threw rocks and it wouldn't leave. Then he said he'd heard some people say if you peed on the snake's head it would leave. He peed on its head, then peed on its tail, and the damn snake still didn't leave! If I recall, he said that eventually, with more and more poking with the poles, the snake finally decided to move out of the way.

SGT Rock
12-14-2004, 11:05
Is long as it isn't singing you can get around them.

zenribbits
12-14-2004, 21:29
Information pertaining on what to do with a snake bite seems to be skewed by the situation, particular product, personal preference and proximity from civilization. It seems to me that this argument is based on if one particular step in the treatment of a snake bite should or should not be included in the treatment at all. As far as the rest of the treatment, we don’t seem to have any discrepancies. People’s posts have ranged from absolutely not, to definitely. Some of the wiser (in my opinion) stated that if utilizing the device satisfies you psychologically, then you should use it. If someone offered me one, I would use it, based on the idea that if even 5% of the toxins were removed, I would be better off. I would also consider it divine intervention that someone had thought to bring one and crossed my path at the same time I was bitten, therefore god is telling me to use it. That is just me.



In all reality the bite is going to catch you in a fatty area, muscular area, or catch you in a vein or artery on the wrist. The best case scenario for a wet bite would be to get bit on a fatty area because the total absorption rate can be as long as 24 hours and proximal muscles would have greater time until they became affected by the necrosis. If I am two days out, I say suck away with the little tube because, if the venom was injected, it would probably overtax my body to the point of collapse before I am able to walk out anyway. If I am an hour away, I say get out of my way! I have a date with the nurse!!!



We have to remember that statistics are statistics. They can be skewed to show whatever you want. The fact that no one has been bitten on the trail in x amount of years doesn’t comfort me at all. That only indicates on the trail. The books blatantly state that I will need to leave the trail to find shelters, water sources, and the occasional privy. If I get bit at any of those locations, the statistic will still hold true. Plumorchard Gap Shelter is a great example of potential snake encounters during hikes along the AT. Although the “has” leads me to believe that they have been removed, it is also an indication of how real the potential threat of venomous snake encounters are along the trail.



*out of the 2004 thru-hikers` companion*

“Plumorchard gap shelter (1993) – sleeps 14. Privy. The stump in the front of the shelter has been a residence of copperhead snakes. Water source is a creek that crosses the trail or a spring located 200 yards west of the A.T. opposite the shelter trail.”

** Please note I am planning on avoiding the Plumorchard gap shelter if at all possible.



The bottom line (as I see it) with this discussion is that regardless of if you do or don’t use the extractor, you have an unsatisfying trek back to civilization that will probably take at least a couple of hours if you are lucky. This is why I propose we re-classify the extractor as a luxury Item and not a first aid item. I say this because as long distance hikers we don’t carry the recommended first aid kit of band aids and ointment; we use common sence and multi purpuse items such as duct tape (which would also be frowned upon by medical journals as it can cause more complications than good. ie trapping bacteria inside, glue inside wound, tissue damage due to removal, loss of circulation due to swelling, ect) and maybe some gauze (I have cheesecloth in my cooking kit) If you do manage to utilize the extractor to its fullest potential, you will STILL need treatment regardless if it was a wet bite or not.

In short, snake bite bad, treatment good, extras are luxuries.

orangebug
12-14-2004, 22:23
Plum Orchard Shelter is no nasty snake den. Copperheads, if they are there, are the less dangerous than rattlesnakes. If you think that Plum Orchard is unique as a snake residence, you are apt to meet an asp in another venue. (Actually, these are pit vipers and not asps, but I liked the alliteration.) You are more likely to meet a rattler around the rocks of PA, VA and NJ than Plum Orchard Shelter.

And it would be terribly amazing if you managed to get a snake bite that penetrated artery or vein. The most common is on the hand and forearm related to unwise attempts to pick up the snake and tell your friends "lookie here!" These are not nearly as vascular as your neck, axilla and groin.

And medical authorities aren't going to give you trouble for treating lacerations, blisters and other wounds with duct tape. Duct tape's adhesives haven't been tested as hypoallergenic, but we all know that it is strong on wet and dry situations and can be used to fashion pressure dressings and wound closures pending more definitive treatment.

The Sawyer Extractor is likely to remain in the first aid kit of maintenance groups and other organized parties of hikers. This is due more to liability and insurance issues than to any probability of injury from snake bite. Anything you choose to put in your pack is a neccessity for you, and possibly a luxury item for others.

Happy
12-15-2004, 02:14
[QUOTE=orangebug]Plum Orchard Shelter is no nasty snake den. Copperheads, if they are there, are the less dangerous than rattlesnakes. /QUOTE]

I agree and I remember the thread that Hammock Hangar made that statement on this forum long ago...just not true today...most shelters have residence snakes to contol the mice. In fact Plum Orchard Shelter is my favorite on the GA section! :clap

zenribbits
12-15-2004, 20:14
My apologies. I must yield to your extensive medical, insurance, veterinary, statistical, and political knowlege in relation to your well thought out response to my post.