Snake Bite

WHAT YOU SHOULD KNOW:

• A snake bite is a wound that you get from being bitten by a poisonous snake. Poisonous snakes in the United States include coral snakes and pit vipers such as rattlesnakes, cottonmouths, and copperheads. They inject venom (poison) when they bite that can damage your muscles, blood vessels, nerves, and other tissues. When venom is released during a bite, it enters your tissues and spreads to other body parts. Snakes often bite when they are stepped on or picked up. Snake bites are more common from April to September when snakes are more active and people spend more time outdoors. When you are bitten, see a caregiver as soon as possible.
  
  
• Signs and symptoms of a snake bite may appear a few minutes to hours after the bite. You may have pain, swelling, redness, or numbness (no feeling) in the area of the bite. Later as the venom spreads, you may throw up, have a fever or seizures (convulsions), stomach pains, or bleeding. Your caregiver will try to tell what type of snake bit you and he may do blood tests. The main treatment for a poisonous snake bite is anti-venom medicine and a tetanus shot. You may also need antibiotics for your wound or surgery to remove the damaged tissues from it. Early diagnosis and treatment may help prevent your wound from getting worse or you becoming more sick.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Treatment for a snake bite may bring side effects. Anti-venom may cause allergic reactions, such as a rash, itchiness, fever, and muscle pains. You may also have an upset stomach, diarrhea (loose bowel movement), headache, or have trouble breathing. You may develop soreness, redness, or swelling in the muscle where the tetanus shot was given. Even with treatment, your wound may become worse, or you may get very sick from having the poison in your body.
  
  
• Untreated snake bites may lead to more serious problems, such as swelling and infections. Severe swelling may press on the blood vessels and nerves in the area. The venom may spread to other parts of your body. You may have bleeding through your nose or other parts of your body. You may have trouble breathing and your blood pressure may become very low. You may have seizures, go into a coma, or die. People who have high blood pressure or bleeding problems are at a higher risk of problems. Ask your caregiver if you are worried or have questions about your condition, treatment, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Activity

At first you may need to rest in bed. Your caregiver will tell you when it is OK to get out of bed. Avoid moving the part of your body where you were bitten. You may need a splint or elastic bandage to prevent your bitten limb from moving it too much. Ask your caregiver for more information and instructions on splint care.

IV:

Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

Monitoring:

• Limb measurement: Your caregiver may use a measuring tape to measure around your bitten arm or leg. Your limb may be measured from time to time to see if it is getting larger. Limb measurement may be done every 15 to 20 minutes until the swelling in the bitten limb goes away.
  
  
• Neurologic exam: This is also called neuro signs, neuro checks, or neuro status. A neurologic exam can show caregivers how well your brain works after an injury or illness. Caregivers will check how your pupils (black dots in the center of each eye) react to light. They may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

Medicines:

You may need any of the following:

• Antibiotics: Antibiotic medicine may be given to treat an infection caused by germs called bacteria.
  
  
• Anti-venom: This is the main treatment for poisonous snake bites. Most, but not all, poisonous snake bites need this treatment. This is most effective if given within four hours after you are bitten. It neutralizes the venom in your body, preventing it from causing more damage. You may need more than one dose of anti-venom. People who are allergic to papaya or other vaccines may be allergic to anti-venom. Tell your caregiver if you are allergic to any of these or have other allergies or medical conditions.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Td vaccine: This vaccine is a booster shot used to help prevent diphtheria and tetanus. The Td booster may be given to adolescents and adults every 10 years or for certain wounds and injuries.

Tests:

You may need one or more of the following tests:

• Heart monitor: This test is also called an EKG or ECG. Sticky pads are placed on your skin to record your heart's electrical activity. An EKG gives information about how your heart is working. Lie as still as possible during the test.
  
  
• Blood gases: This is also called an arterial blood gas, or ABG. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. Your blood is tested for the amount of oxygen and carbon dioxide in it. The results can tell caregivers how well your lungs are working.
  
  
• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• Stool sample: A sample of your stool or bowel movement (BM) is sent to a lab for tests to check for blood.
  
  
• Urine test: A sample of your urine is collected and sent to a lab for tests.

Treatment options:

You may have the following treatments alone or together:

• Blood transfusion: You will get whole or parts of blood through an IV during a transfusion. Blood is tested for diseases, such as hepatitis and HIV, to be sure it is safe.
  
  
• Dialysis: Dialysis cleans your blood when your kidneys cannot. Extra water, chemicals, and waste products are removed from your blood by a dialyzer or dialysis machine. The dialysis machine does this by passing your blood through a special filter, then returning it back to you. You may need dialysis for a short time, or for the rest of your life. Caregivers will check your vital signs often during dialysis. You may also be given medicines or have blood taken for lab tests during dialysis.
  
  
• Surgery:
  
  
  • Fasciotomy: This is surgery to cut tissues covering the muscles. This decreases pressure on blood vessels and nerves caused by swelling of the injured muscle.
    
    
  • Wound cleaning: If the wound area of tissue damaged by venom becomes large, surgical cleaning may be done. Damaged and dead tissues from the wound will be removed with surgical cleaning.
  
  
• Ventilator: This is a machine that gives you oxygen and breathes for you when you cannot breathe well on your own. An endotracheal (ET) tube is put into your airway through your mouth or nose. You may need a trach if an ET tube cannot be placed. A trach is an airway tube put into an incision (cut) in the front of your neck. The ET tube or trach is attached to the ventilator.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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