A nurse in the emergency department is planning care for a client who received a snake bite

Most snakes aren't dangerous to humans. Only about 15% worldwide and 20% in the United States are venomous. In North America, these include the rattlesnake, coral snake, water moccasin and copperhead. Their bites can cause severe injuries and sometimes death.

If a venomous snake bites you, call 911 or your local emergency number immediately, especially if the bitten area changes color, begins to swell or is painful. Many emergency rooms stock antivenom drugs, which may help you.

If possible, take these steps while waiting for medical help:

• Move beyond the snake's striking distance.
• Remain still and calm to help slow the spread of venom.
• Remove jewelry and tight clothing before you start to swell.
• Position yourself, if possible, so that the bite is at or below the level of your heart.
• Clean the wound with soap and water. Cover it with a clean, dry dressing.

Caution

• Don't use a tourniquet or apply ice.
• Don't cut the wound or attempt to remove the venom.
• Don't drink caffeine or alcohol, which could speed your body's absorption of venom.
• Don't try to capture the snake. Try to remember its color and shape so that you can describe it, which will help in your treatment. If you have a smartphone with you and it won't delay your getting help, take a picture of the snake from a safe distance to help with identification.

Symptoms

Most snakebites occur on the extremities. Typical symptoms of the bite from a nonvenomous snake are pain and scratches at the site.

Usually, after a bite from a venomous snake, there is severe burning pain at the site within 15 to 30 minutes. This can progress to swelling and bruising at the wound and all the way up the arm or leg. Other signs and symptoms include nausea, labored breathing and a general sense of weakness, as well as an odd taste in the mouth.

Some snakes, such as coral snakes, have toxins that cause neurological symptoms, such as skin tingling, difficulty speaking and weakness.

Sometimes, a venomous snake can bite without injecting venom. The result of these "dry bites" is irritation at the site.

Venomous snakes in North America

Most venomous snakes in North America have eyes like slits and are known as pit vipers. Their heads are triangular and they have fangs. One exception is the coral snake, which has a rounded head and round pupils. Nonvenomous snakes typically have rounded heads, round pupils and no fangs.

Aug. 12, 2021

1. Snakebites. Merck Manual Professional Version. https://www.merckmanuals.com/professional/injuries-poisoning/bites-and-stings/snakebites?query=snake%20bite. Accessed June 24, 2019.
2. Papadakis MA, et al., eds. Poisoning. In: Current Medical Diagnosis & Treatment 2019. 58th ed. New York, N.Y.: McGraw-Hill Education; 2019. https://accessmedicine.mhmedical.com. Accessed June 24, 2019.
3. Seifert SA. Evaluation and management of Crotalinae (rattlesnake, water moccasin [cottonmouth], or copperhead) bites in the United States. https://www.uptodate.com/contents/search. Accessed June 24, 2019.
4. Venomous snakes. Centers for Disease Control and Prevention. https://www.cdc.gov/niosh/topics/snakes/. Accessed June 24, 2019.
5. Venomous snakes: Types of venomous snakes. Centers for Disease Control and Prevention. https://www.cdc.gov/niosh/topics/snakes/types.html. Accessed June 24, 2019.

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Case Reports

. 2022 Jul 5;30(4):25-31.

doi: 10.7748/en.2021.e2113. Epub 2021 Nov 9.

Affiliations

• PMID: 34751520
• DOI: 10.7748/en.2021.e2113

Case Reports

Assessment and management of snake bites in the emergency department

Karen Chivers et al. Emerg Nurse. 2022.

Abstract

Snake bites are a relatively rare presentation to emergency departments in the Western world. In the UK, there were 510 cases of snake bites between 2004 and 2010. However, it is important that nurses are aware of how to assess and manage these presentations and understand the importance of ascertaining information on factors such as the type of snake involved and how long the snake was biting the patient for. This article uses a case study to discuss the assessment and management of snake bites, and provides information on the steps nurses should take to manage patients presenting with a snake bite.

Keywords: bites and stings; emergency care; nursing care; professional; signs and symptoms; urgent care; wound assessment; wound care.

© 2021 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Conflict of interest statement

None declared

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