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Interviewer: Snakes, ugh. Snake bites, double ugh. We are with poison expert, Brad Dahl. He's from the Utah Poison Control Center. I should say Dr. Brad Dahl. Let's talk about snakes for a minute here. Poisonous snakes here in Utah area, rattlesnakes, that's the only game, right?
Dr. Dahl: Yeah. The rattlesnake is the only venomous snake that lives in the wild in Utah.
Interviewer: All right. I'm out hiking and I get bite by one. What next?
Dr. Dahl: Well, the best thing to do, and this is a very difficult thing to do, is to not panic because I've got to be honest with you, even knowing what I know, I would probably come close to freaking out.
Dr. Dahl: Because if you can keep your rate and everything else as calm as possible, you're going to do much better. Just know that we can help you. Okay. You're not going to die from this.
Interviewer: So rattlesnake bites... not lethal?
Dr. Dahl: Very rarely. It does happen every so often. The worst things that we see here in Utah is when people do things they shouldn't do.
Interviewer: Like try to kiss a snake?
Dr. Dahl: Well yeah. Yeah, yeah, that's not a good idea. We don't recommend kissing snakes. But, yeah, the number one thing is what used to be in the Boy Scout manual and that is put a tourniquet on. Number one, you're not going to stop the flow of venom through your body. Once it enters your body it's on its way.
Interviewer: And, no, that doesn't help at all? A tourniquet is just a waste of time?
Dr. Dahl: No. It doesn't help at all. It also inhibits your body's ability to attack the venom itself with your own immune system. So you want your body to let it do its thing. You want to stay calm and don't do that because otherwise, you can actually tissue at the bite site. Which, Utah typically is going to be the hand.
Interviewer: Oh, it is? The hand is the most likely to get bit?
Dr. Dahl: It's very unusual to see people bit in the foot here in Utah. In the last 20 years, we've had probably less than 10 bites on the foot. Yeah, in the entire state.
Interviewer: So snakes, snakes cannot penetrate if you're wearing sensible footwear?
Dr. Dahl: Yeah, that's true. So if you're out hiking where there could be snakes, you definitely want to wear some good boots and you want to wear jeans. There's actually been a study done on people wearing jeans and it's protecting them from being envenomated. That's the other thing too. Just because you're bit by a snake doesn't mean they injected venom in you. Although most of the time they do. So I always like to be an optimist. It's like, "Oh, I was bit by a rattlesnake. Hey! Maybe I wasn't envenomated."
Interviewer: But just imagine, treat it as though it did. What about those snake bite kits? I went and bought one of those things in the yellow tube, got the razor blade, you're supposed to suck them out. Does that work?
Dr. Dahl: No, but the interesting thing is I've never seen anybody who had a venom extraction kit get bit. So I think it is somewhat protective.
Interviewer: Really? That's interesting.
Dr. Dahl: Yeah, just, yeah.
Interviewer: But actually the kit itself and the act of cutting and trying to get the poison out, at that point it's too late.
Dr. Dahl: No. There have actually been studies done with injecting non-poisonous stuff into people and trying to extract it out with a venom extraction kit and they've not been able to get out anything, significant anyway. So it's pointless to do it. Usually, when you're out hiking you've got a knife there, it's not sterile. If you start cutting into things, start cutting into things. Yeah. We've had people cut and do some real damage with the knife, trying to cut and get the venom out. Yeah. We do not recommend doing that. So yeah, what Hollywood teaches us is not the right thing to do. Do not cut and suck. The Boy Scouts, they've changed their manual now. So no more tourniquets.
The other thing people think of doing is putting ice on it. And the one thing it does do that's kind of good is it numbs the pain. But the other thing it does that is not so good is it inhibits blood flow to the area. So, again, we do not recommend putting ice on it as well.
Interviewer: So they don't kill us, but what's that venom going to do to us? If I'm a couple, three miles out and I get bit, I've got to walk two or three miles to get cell phone reception. What am I dealing with at that point?
Dr. Dahl: Yeah. Well, certainly the sooner we can get you help, the better. Yeah, you're okay to walk. If you're not, if you don't feel you're okay to walk, then you can stay there if you're with somebody else. That's why it's always good not to hike alone, kids. You can send them out to call somebody and they can come in and get you. So getting you help is probably the best thing you can do as soon as possible. And not waiting to see if it's going to be a problem because if you wait for four or five hours and you come in and your arm is swollen all the way to your elbow or beyond, up to your shoulder, you're going to end up with some pretty good tissue damage.
Interviewer: I'm not doing more damage by trying to walk out, that's what you're telling me?
Dr. Dahl: No. That is correct. If you're bit on the hand, which is the classic thing, you can put your arm in a sling. You don't want to be aggressively swinging it around and things like that. So it's okay to do that and try to keep it immobile. And to not run out. Try to keep your heart rate as normal as possible. But hike out as calm as you can and as soon as you get a cell signal, call 9-1-1 to get somebody out there to get you. Interviewer: Okay. That's completely okay to do that?
Dr. Dahl: It's totally okay to do that.
Interviewer: That is a reason to call 9-1-1 and have somebody show up.
Dr. Dahl: Yeah. That's not a problem at all. We would encourage that. And obviously, if you get to the trail head and you've got your car there and the hospital is within an hour's drive, you're probably okay just to drive to the hospital.
So the worst thing you can do is think, "Oh, this snake is on the trail. That could hurt somebody. I'm going to move the snake off the trail," find a stick to go get it. And the next thing you know, you got bit on the hand. So leave the snake alone. It will move. Or, if it's on the trail, tell other hikers as you pass them. "Hey, guess what? There's a rattlesnake up there. So be careful. When you see it, go around it."
Interviewer: Trust me, Dr. Dahl, when I see a snake, the other hikers around me know. It sounds like I blew my knee out usually when I see a snake. All right.
Dr. Dahl: I'm with you there. They scare me too.
Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there’s a pretty good chance you’ll find what you want to know. Check it out at TheScopeRadio.com.
updated: June 18, 2019
originally published: July 22, 2015
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