The Science of Venom and Snakebite Care

Feeling anxious about snakes is extremely common worldwide, and ranges from slight unease all the way to diagnosed ophidiophobia, which is an intense phobia with serious symptoms! Even harmless, nonvenomous snakes cause people to feel uneasy; there’s just something about snakes that we don’t trust. In my opinion, it doesn’t have to be that way. Most snakes are very shy and would rather avoid people if given the opportunity to escape. 

But snakebites do happen, and being knowledgeable and prepared can help make a bad situation better. 

Nerding Out on Snake Venom

Snakes have evolved venom for defense and as a way to subdue prey, and the venom composition of each species is a little different. It can even vary geographically or among individual snakes. Venomous snakes have hollow fangs that administer venom into subcutaneous tissue. The biochemical makeup of venom includes enzymes, macromolecules and metallic toxins with varying effects on the bite recipients’ proteins. 

In rattlesnakes, venom has evolved as a way for the snakes to subdue their prey, and it contains certain digestive enzymes to aid in this process.

Hemotoxins cause hemorrhaging in tissues and the necrosis of tissue and blood. Phospholipases cause platelet destruction and attack the cell membranes, as well as disrupting cellular communication, leading to localized paralysis. Metalloproteases trigger an immune response and cause the immune system to attack itself. Timber rattlesnakes, the species responsible for the majority of rattlesnake bites in the United States, also have compounds with neurotoxic effects in their venom, causing localized quivering.

Venom Effects

You could read into the biochemical components of snake venom all day, but what about the actual effects they have on the human body? Pain and swelling at the bite site, nausea, vomiting, lightheadedness, excessive saliva production, tissue necrosis, bleeding, pain up the bitten extremity, sweating, and numbness are all possible signs and symptoms. Not every snakebite is a venomous bite, either. Even venomous snakes will “dry bite”, in which no venom is administered. 

Prehospital Treatment

The good news is, in the United States, fatalities from snakebite are relatively infrequent. Most fatalities have one thing in common: delayed or no treatment. Among rattlesnake bites, the case fatality rate in the US is 1 death per 736 bites. Getting to the hospital for proper treatment is essential, but in the meantime…

• Remove watches, jewelry, hair ties… anything restrictive that will have a negative interaction with swelling. 
• Don’t try to cut the bite, suck out the venom, or use any kind of sucking device to try to remove the venom. 
• Keep the victim as still as possible. 
• If the bite is in an extremity, keep it above or at heart level to reduce the chances of permanent tissue damage. For rattlesnake bites, keep the extremity at heart level, and for copperhead/cottonmouth bites, elevate the extremity above heart level. 
• Cover the bite site with a loose, clean bandage. 
• No tourniquets! This is to help prevent tissue damage. 
• If possible, ID the snake with a photo. 

Once at the hospital, the victim may receive antivenom. CroFab is the antivenom approved for all North American pit viper bites. Antivenoms are made by inoculating an animal such as a sheep or horse with snake venom, then collecting the serum from the animal. It’s expensive but improves prognosis and reduces permanent damage in snakebite victims. 

Snakes deserve our respect and care just as much as any other animal. Being able to respect their space when we have to live with them just makes life better for everyone! The biggest takeaway is that with good prehospital and hospital treatment, fatal snakebites are rare in the United States. Staying calm and having some knowledge of venomous snakes can go a long way toward a good outcome.

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