What is Rattle Snake Toxicity (Snake Bite)?
Rattlesnakes are located all across the Americas, including nearly every state in the U.S., except for Alaska and Hawaii. These snakes belong to the groups Crotalus and Sistrurus, part of a larger group often referred to as pit vipers. Other dangerous snakes in this group include Lanceheads, Copperheads or Cottonmouths, and Asian Palm Pit Vipers. Their main way of protecting themselves is by hiding, but they’ll also make a rattling sound and hiss to scare off any threats. If they feel they’re still in danger, they may bite and inject venom into the threat, which can be potentially life-threatening. That’s why it’s important to know what types of snakes are common in your area, so you can respond correctly if bitten.
What Causes Rattle Snake Toxicity (Snake Bite)?
When someone gets bitten by a snake, the sickness and even potential death that can follow is usually because of venom, a poisonous substance, that the snake injects. Surprisingly, snake bites usually don’t become infected. This is because the snake’s venom can slow down the growth of microorganisms that usually cause infections.
People usually get bitten when they accidentally step on snakes or come too close to them while they’re hiding. Sometimes, the rattling sound made by some snakes can alert people to their presence. However, it’s possible for a snake’s tail to not work properly and not produce any sound, possibly because those snakes that do rattle have been killed off in populated areas.
Most of the deaths related to snake bites are due to immediate allergic reactions or because the person bitten by the snake didn’t get medical help in time to receive anti-venom treatment. Anti-venom is a medication that helps fight off the harmful effects of the venom. Snake bites often occur when people fail to handle snakes correctly, or tease snakes for amusement. This notably includes professional snake handlers, who face an unfortunate risk of snake bites due to their work.
Risk Factors and Frequency for Rattle Snake Toxicity (Snake Bite)
Snakes bites are quite common in the United States, with more than 99% of them coming from pit vipers, and rattlesnakes causing over half of these bites. The severity of snake bites can vary, but bites from rattlesnakes are often more deadly.
- Every year, about 9,000 people in the US get bitten by snakes.
- Despite the large number of snake bites, deaths are relatively rare, with only five per year on average.
- Alarmingly, data from poison centers show that 1 out of every 736 rattlesnake bite victims actually dies.
- Most often, the unfortunately bitten individuals are young males who are intoxicated.
- Rattlesnakes can be found in a wide range of climates throughout North and South America.
Signs and Symptoms of Rattle Snake Toxicity (Snake Bite)
If someone is bitten by a rattlesnake, they may see and feel various signs and symptoms. Usually, the place where they were bitten will show fang marks. Local symptoms – symptoms at the site of the bite – can include pain at the site, swelling, and bleeding. In more severe cases, tissue around the bite might die, and bruising can occur. Systemic symptoms – symptoms affecting the whole body – can include swelling caused by fluid buildup, bleeding from other parts of the body, nausea, vomiting, diarrhea, shortness of breath, and severe allergic reactions.
A good medical history should include a description of the snake provided by the victim or witnesses, as this might help identify if the snake was venomous or not. It’s often not possible to determine the type of snake based on a person’s report, however. Information should also be gathered about any existing health conditions like blood clotting disorders, a weakened immune system, or the use of blood thinning medications.
- Fang marks at the bite site
- Pain at the bite site
- Swelling
- Bleeding at the bite site
- Tissue death around the bite (in severe cases)
- Bruising (in severe cases)
- Body-wide swelling
- Bleeding from other body openings
- Nausea
- Vomiting
- Diarrhea
- Shortness of breath
- Severe allergic reactions
Testing for Rattle Snake Toxicity (Snake Bite)
If you’ve been bitten by a snake, your doctor will be able to diagnose based on your symptoms alone – there isn’t a test that can confirm the bite or tell what kind of snake bit you. However, a blood test can still be helpful to guide the treatment process. If you’re bitten by a snake, your doctor will likely order a blood test, checking for things like:
- Your complete blood count (CBC).
- The level of various substances in your blood (serum chemistry).
- Your body’s ability to form blood clots (coagulation panel).
- The level of a specific protein that helps your blood clot (fibrinogen).
- The level of a substance in your blood that’s released when your muscles are hurt (creatine kinase).
Your doctor may also want a urine test to check for a protein called myoglobin, which can help them to find out if your muscles were damaged by the snake bite. Although an x-ray isn’t usually necessary, if your doctor thinks there may be something foreign left in the wound or that you’ve fractured a bone while escaping the snake, they might request one.
When you first arrive to see your doctor, they’ll look for and mark the furthest point reached by any swelling or redness around the snake bite. They’ll also check your limbs to make sure blood is flowing correctly and your brain is getting the messages it should be. Your doctor will also frequently check the swelling to see if it’s getting worse over time.
Depending on the severity of the snake venom’s impact on your body, your doctor will decide whether to give you antivenin (a treatment that combats the venom). Severity levels can be categorized into:
- Minimal Envenomation: The swelling, pain, and bruising is limited to the bite area, and there are no systemic signs. Your blood’s ability to form clots is normal or showing mild changes with no actual bleeding.
- Moderate Envenomation: Swelling, pain, and bruising involves less than a full limb or extends less than 50 cm in adults. You might experience whole-body (systemic) symptoms like vomiting, slight low blood pressure (mild hypotension), and a faster than normal heart rate (mild tachycardia). Your blood test might show that your body’s ability to clot blood is not normal, but this doesn’t lead to actual bleeding.
- Severe Envenomation: Swelling, pain, and bruising involves a whole limb or more, and could even be threatening your airway. Systemic symptoms could include altered mental state and unstable blood pressure and heart rate (hemodynamic instability). The blood’s ability to form clots might be abnormal and lead to actual bleeding.
The grades mentioned above help your doctor to decide whether giving you antivenin is necessary. However, if the grading is minimal, antivenin is typically not needed.
Treatment Options for Rattle Snake Toxicity (Snake Bite)
If you’ve been bitten by a rattlesnake, the first and most important thing is to get to a medical professional quickly. If possible, try not to move the part of your body where you were bitten too much. This can help slow down the spread of the venom, but getting medical help quickly is the top priority. When you get to the hospital, the doctors and nurses will immediately check your vitals, like your breathing, your pulse, and whether you can speak properly. You might be able to tell them what kind of snake bit you, but don’t worry if you can’t – treatment for snakebites doesn’t change much based on the type of snake.
The doctors will keep a close eye on the area around the bite. They’ll mark where the swelling and redness start and keep an eye on how quickly they’re spreading. You’ll be given strong painkillers if you need them, and the doctors will test your blood for signs the venom is affecting you. They’ll double-check you’re up-to-date on your tetanus vaccine, and call a poison expert for advice.
Signs that the venom is having a serious effect on your body can include things like low blood pressure, bleeding, vomiting, diarrhea, swelling in the face or tongue, and difficulty breathing. If you’re having trouble breathing, the doctors will help make sure your airway stays open.
If you seem okay, you’ll still be kept in the hospital for at least eight hours. The doctors will test your blood again for signs the venom has affected your blood’s ability to clot. If the swelling is getting worse, or you’re showing signs of being seriously affected by the venom, you’ll be given an antivenom. In North America, two different types of antivenom are commonly used.
Both of these types of antivenom work by binding to the venom, neutralising its effects. They’re all made by getting a specific type of snake to bite an animal (either a sheep or a horse, depending on the type of antivenom), and then collecting the antibodies that the animal makes to fight off the venom.
These antibodies are then purified and given to patients through a drip. Once the doctors are sure the antivenom isn’t causing any side effects, it will be given over about an hour. The doctors will keep a close eye on you to make sure the swelling stops and your symptoms improve.
After that, you’ll be given an additional dose of the antivenom every six hours for the next day or so. This helps make sure the venom is fully neutralised. It’s important however to check back for a couple of days after the bite for new symptoms, as the venom can sometimes cause problems with the blood clotting – a delayed coagulopathy. In that case, you may need more of the antivenom.
What else can Rattle Snake Toxicity (Snake Bite) be?
Here are some medical conditions and situations that may require immediate attention:
- Anaphylaxis (severe allergic reaction)
- Deep vein thrombosis (blood clot in a deep vein, usually in the leg)
- Extremity vascular trauma (damage to the blood vessels in an arm or leg)
- Scorpion Envenomation (poisoning from a scorpion sting)
- Septic shock (a serious infection that causes your blood pressure to drop)
- Serum sickness (a reaction to certain medications or antiserum)
- Wasp stings
- Wound care (treatment of an injury)
- Wound infection
What to expect with Rattle Snake Toxicity (Snake Bite)
While rattlesnakes are often thought of as more deadly than other types of pit vipers, the death rate related to their bites is actually quite low, particularly if medical help is given promptly. According to the U.S Poison Control Center, data collected from 1983 to 2007 indicates that for every 736 patients bitten by rattlesnakes, about one person died.
More recent information from the North American Snakebite Registry, a large database of detailed and current information about snake bites in the United States, shows there were no reported deaths from 256 rattlesnake bites from 2013 to 2015. However, bites from rattlesnakes did result in a higher number of victims needing to stay in the hospital for more than 72 hours, compared to bites from other types of snakes, such as copperheads, cottonmouths, and coral snakes.
Therefore, even though the death rate from rattlesnake bites is low, the effects can still be quite serious and require substantial medical treatment.
Possible Complications When Diagnosed with Rattle Snake Toxicity (Snake Bite)
If a rattlesnake bite happens, there can be complications either from the venom itself or the treatment.
One potential complication could be a severe allergic reaction, known as anaphylaxis, while getting treatment with the anti-venom, Crotalidae polyvalent immune Fab. People could also experience delayed allergic reactions or serum sickness, which can be treated with oral steroids for about 5 to 7 days.
There’s a major complication related to rattlesnake bites that gets a lot of attention – tissue death, or necrosis. In one study, around 40% of people bitten by a rattlesnake on their upper body showed signs of their tissue dying off. In severe cases, this might need surgical cleaning or, in the worst cases, amputation.
Infections can occur with tissue death, but the incidents of infection without tissue death from these types of snakebites are relatively low at around 3% in one study.
The snake venom could also damage muscles enough to cause rhabdomyolysis, which can then harm the kidneys. Rising levels of CPK, a type of enzyme, could be an indication to look out for signs of compartment syndrome, a painful condition that usually responds to more anti-venom.
Rattlesnake venom can also have delayed effects even after initial treatment. About half the people treated with anti-venom could see local swelling. Recurrences of blood clotting issues can happen for up to two weeks after treatment. Additional doses of anti-venom may be needed. If left untreated, this could escalate to serious bleeding.
Rattlesnake bites can on rare occasions lead to compartment syndrome. While this usually resolves with more anti-venom and conservative treatment, some cases might require surgical intervention.
- Severe allergic reactions (anaphylaxis) during treatment
- Delayed allergic reactions or serum sickness
- Tissue death (necrosis)
- Infections related to tissue death
- Rhabdomyolysis from muscle damage
- Delayed venom effects with possible local swelling and recurring clotting issues
- Compartment syndrome
Preventing Rattle Snake Toxicity (Snake Bite)
If you get bitten by a rattlesnake, it’s crucial to get medical help quickly at the nearest emergency room. While there are many suggestions in TV shows and movies, there are things you definitely should NOT do after a snake bite.
Don’t attempt to kill or catch the rattlesnake for identification or even try to carry it, alive or dead. Don’t put a tight band (tourniquet) above the bite mark. Don’t place ice on the area where you were bitten. Never try to pull out the venom from the bite, whether using a store-bought device or by cutting the wound open. Lastly, don’t try to treat the venom by applying electric shocks to the bite. These actions can potentially make things worse.
