Paramedic’s Corner: What to do when a copperhead snake strikes (Part I)
By: Ambulance Director Gary Carmack
Posted: Tuesday, July 28, 2009 2:36 pm
Ambulance Director Gary Carmack
Although people fear snakes, the reality is that snakebite deaths in the United States are rare.
Out of the 7,000 to 8,000 poisonous snakebites reported each year, only a small number — fewer than five to six per year — result in death. Most of these deaths are in the elderly, children, members of religious sects who handle venomous snakes, and untreated or undertreated cases.
Rattlesnakes account for most venomous snakebites and for nearly all of the deaths. The copperhead, which is common locally, is one of the venomous snakes of the family Crotalidae (pit vipers). Pit vipers of North America include rattlesnakes, copperheads, and cottonmouth moccasins. Pit vipers are not naturally aggressive, although some such as the cottonmouths seem to be more easily irritated than others. My grandparents and my mother, who grew up on the Gasconade River, have told me stories of cottonmouths actually chasing and attempting to get in a boat with them.
By comparison, the copperhead does not seek out people and attack. Nearly all cases of copperhead bites are when the snake is surprised. For example, if someone walking in the woods steps on one, the snake might strike in self-defense.
When they do strike, it is with lightning speed. The snake’s fangs snap forward from their folded-back position and the snake tries to inject venom. This venom is a mixture of enzymes that cause tissue damage, leakage in the vasculature system, blood clotting abnormalities, and a dysfunction of the neuromuscular system.
This injection attempt is a very important part of the snakebite story. The injection is variable, anywhere from no venom to a potentially lethal dose. Not all snakebites will contain venom. Many times the snake doesn’t get a good bite and just doesn’t inject. As a matter of fact, one out of every four pit viper bites is “dry.” In other words, there are no signs or symptoms of venom release, which is called envenomation.
The most common signs and symptoms of envenomation following snakebite are fang marks, immediate burning pain and rapid swelling around the area of the bite. Pain and rapid development of swelling, usually within 15 to 30 minutes, is an indication that envenomation did occur. However, a word of caution: often the envenomation reaction is delayed up to six to eight hours. This is why the snakebite victim should be observed in the hospital for at least 12 hours.
Other signs and symptoms include nausea and vomiting, dizziness, weakness, oral numbness or tingling of the mouth and tongue. Some people describe a metallic taste in the mouth. Severe anxiety, rapid heart rate, low blood pressure, rapid breathing, and muscle fasciculation, which involves brief spontaneous contractions of muscle fibers, can also occur.