Rattlesnakes
Are rattlesnake bites becoming more dangerous?
PHOENIX – With the onset of triple digit temperatures in central Arizona, the Banner Poison Control Center reminds residents to use extra caution and keep a watchful eye when walking, hiking or climbing in the desert and surrounding mountain parks. Homeowners living near these areas should also be aware of these desert dwellers.
The Banner Poison Control Center, located at Banner Good Samaritan Medical Center, is one of the nation’s busiest poison centers in treating rattlesnake bites. Specialists at the center received 14,000 calls concerning persons bitten or stung by snakes, scorpions, spiders or other venomous creatures in 2007. Seriously ill victims are admitted to area hospitals or transferred to Banner Good Samaritan for care by physician toxicologists with the poison center.
Toxicologists with the Banner Poison Control Center, though, have noted a disturbing trend with rattlesnake bites over the past few years, and took additional steps this week to warn emergency physicians and hospital emergency departments in Maricopa County and outlying Arizona hospitals.
“Over the last 5-6 years, we have noticed an increased incidence of critically ill rattlesnake bite patients being admitted to our service,” wrote Dr. Steven Curry, director of Medical Toxicology, and his colleagues at the Banner Poison Control Center. “The collective clinical findings in these patients mimic aspects of anaphylaxis and commonly include one or more of the following:
- Rapid collapse within a few minutes of being bitten;
- Hypotension and shock, commonly requiring epinephrine;
- Rapid, profound third-spacing of fluids with hypovolemia and hemoconcentration, sometimes with only minimal or absent swelling;
- Swelling or angioedema of the lips, tongue and throat, sometimes requiring emergency airway management; and
- Profound weakness and/or diarrhea.”
Toxicologists cannot say why bite victims are experiencing such severe and life-threatening symptoms more commonly. In the few cases where physicians with Banner Poison Control Center have been able to examine the rattlesnake responsible for envenomation, it has been a Mojave rattlesnake. However, the responsible species of rattlesnakes in most cases has not been identified.
“We never recommend that any attempt be made to capture or kill the offending snake because of the danger involved,” Dr. Curry said. “Therefore, we don't know that Mojave rattlesnakes, alone, are responsible for an increasing frequency of severely envenomated patients.
“Physician toxicologists with Banner Poison Control Center have admitted about 50 to 75 rattlesnake bite patients annually for nearly 30 years,” Dr. Curry added. “Prior to 2002, we saw patients with the above findings about once every 2-3 years. Now we see several of these patients each year, and have recently become aware of similar patients in nearby states.”
Dr. Curry and his colleagues have communicated with poison center toxicologists in Tucson, Southern California and Colorado, where similar patients have been seen.
“Rattlesnake bites, most commonly, result in immediate onset of pain and then progressive swelling. Rattlesnake venom also impairs clotting of the blood,” said Dr. Curry. “Even baby rattlesnakes are capable of a venomous bite.”
Most bites occur when the victim chooses to disturb or handle the snake, so Dr. Curry recommends walking well away from a snake and avoiding it altogether. Others victims inadvertently get too close without realizing the snake is present.
Victims of a snakebite should remain as calm as possible and seek immediate medical attention from a hospital emergency room, where they can be evaluated and, if needed, receive antivenin and other treatment.
Tips to follow if a rattlesnake has bitten you:
- DO NOT apply ice to the bite site or immerse the bite in a bucket of ice.
- DO NOT cut the bite site or try to suck out the venom. Leave the bite alone.
- DO NOT try to capture the snake to bring it to the hospital. Identification of the snake is not necessary for treatment. Besides that, you could be bitten again.
- DO NOT use a constricting band, cloth or tourniquet. It’s important not to restrict blood flow in any manner.
- If bitten on the hand, remove all jewelry from the bite area as soon as possible because the area can swell up quickly.
- Call “911” or the Banner Poison Control Center at 1 (800) 222-1222.
The Banner Poison Control Center Hotline received more than 105,000 phone calls for exposures in 2007, including:
- 54,000 human exposures to toxins and poisons
- 23,000 pediatric exposures age 12 and under
- 27,200 exposures age 19 and under
- 14,000 persons bitten or stung by snakes, scorpions, spiders or other venomous creatures
- 45,370 calls for identification of drugs, information concerning teratogens (agents causing birth defects) and drug information
- Nurses and poison control experts made more than 150,000 outgoing follow-up calls to provide home management.
Approximately 41,000 exposed persons were treated in their own home without a trip to an emergency department, and the Poison Center experts made more than 150,000 outgoing follow-up calls to provide home management. Based on surveys of callers to the poison center, 29,000 of these cases would have gone to nearby hospital emergency departments needlessly, with the poison center preventing more than $30 million in unnecessary healthcare bills.
If you need poison help the Banner Poison Control Center is just a phone call away and can be reached at 1 (800) 222-1222. The center provides a free, 24-hour emergency telephone service for both residents and medical professionals of Maricopa County and parts of Pinal County.
The Poison Center nurses provide information about poisonous substances, first aid information, treatment recommendations, drug identification and information, and a healthy dose of support and caring to all callers. Non-emergent information may also be obtained by
e-mail: poisoncenter@bannerhealth.com.
Contact:
Banner Good Samaritan Public Relations
(602) 239-4411
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