And just as in , two eternal questions remain critical: was it truly a deadly serpent, and did it inject enough venom to kill? Dr Peter Hobbins is an ARC DECRA Fellow and a historian of science, technology and medicine in the Department of History.

Dr Hobbins received his PhD from the University of Sydney in , where he was awarded the Rita and John Cornforth Medal for PhD Achievement.

This article was originally published on The Conversation. This article was selected for The Conversation Yearbook 50 standout articles from Australia's top thinkers. Biologist Professor Rick Shine has won the Prime Minister's Prize for Science, while early career researcher Professor Richard Payne has been recognised in the physical sciences category for his medicinal chemistry developments.

Hissstory: how the science of snake bite treatments has changed. Dr Peter Hobbins. The Department of History Read more. Annika Dean. Assistant Media and PR Adviser Humanities and Social Sciences. Related articles.

Fear of death underlies most of our phobias This article was selected for The Conversation Yearbook 50 standout articles from Australia's top thinkers. University of Sydney leads Prime Minister's Prizes for Science Biologist Professor Rick Shine has won the Prime Minister's Prize for Science, while early career researcher Professor Richard Payne has been recognised in the physical sciences category for his medicinal chemistry developments.

If you encounter a snake, give it space to retreat and let it take cover. When working outside where snakes may be present, wear tall boots, long pants, and leather gloves. Avoid working outside during the night and in warmer weather, which is when snakes are most active.

Learn about rattlesnake bites, including how to treat them and the expected timeline. Tetanus, also called Lockjaw, is a serious bacterial infection that affects the nervous system and causes muscles throughout the body to tighten.

A honey bee sting usually just causes temporary pain. Radiation poisoning happens after exposure to very high doses of radiation. Learn about the causes, how it affects the body, and what to do in an….

Learn how ricin poisoning occurs, the signs and symptoms of poisoning, and what to do if you're exposed. The angel's trumpet is a beautiful plant, but the leaves and flowers are poisonous to humans and animals. Let's look at the effects of this flowering…. Mad hatter disease is a form of chronic mercury poisoning.

It got its name because it commonly affected hat makers in the 18th to 20th centuries. The chemicals used to cool appliances like air conditioners are known as refrigerant. A Quiz for Teens Are You a Workaholic?

How Well Do You Sleep? Health Conditions Discover Plan Connect. Snake Bites. Medically reviewed by Judith Marcin, M.

Identifying snakes Rattlesnakes Water moccasins Copperheads Coral snakes First aid Treatment Outlook Prevention What are snake bites? Identifying venomous snakes. Share on Pinterest. Water moccasins or cottonmouths. Coral snakes.

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Key facts Always seek emergency medical treatment for snake bites, as they can be life-threatening. Snake bites may cause pain and swelling around the site of the bite, or there may be very few signs left on the skin. Symptoms that snake venom has entered your body may include dizziness, blurred vision, breathing difficulties, nausea, muscle weakness or paralysis.

Most snake bites occur when snakes are disturbed; the best way to prevent being bitten is by avoiding snakes altogether. Back To Top. General search results. Snakebite first aid can be very effective if done quickly.

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In Africa, it is mambas , Egyptian cobras , puff adders , and carpet vipers. In the Middle East, it is carpet vipers and elapids. In Latin America , it is snakes of the Bothrops and Crotalus types, the latter including rattlesnakes. Since envenomation is completely voluntary, all venomous snakes are capable of biting without injecting venom into a person.

Snakes may deliver such a " dry bite " rather than waste their venom on a creature too large for them to eat, a behaviour called venom metering. Some dry bites may also be the result of imprecise timing on the snake's part, as venom may be prematurely released before the fangs have penetrated the person.

While not as life-threatening as a bite from a venomous species, the bite can be at least temporarily debilitating and could lead to dangerous infections if improperly dealt with. While most snakes must open their mouths before biting, African and Middle Eastern snakes belonging to the family Atractaspididae are able to fold their fangs to the side of their head without opening their mouth and jab a person.

It has been suggested that snakes evolved the mechanisms necessary for venom formation and delivery sometime during the Miocene epoch. As open grasslands replaced forested areas in parts of the world, some snake families evolved to become smaller and thus more agile.

However, subduing and killing prey became more difficult for the smaller snakes, leading to the evolution of snake venom. Snake venom is produced in modified parotid glands normally responsible for secreting saliva. It is stored in structures called alveoli behind the animal's eyes, and ejected voluntarily through its hollow tubular fangs.

Venom in many snakes, such as pit vipers, affects virtually every organ system in the human body and can be a combination of many toxins, including cytotoxins , hemotoxins , neurotoxins , and myotoxins , allowing for an enormous variety of symptoms.

The lymphatic system may be damaged by the various enzymes contained in the venom leading to edema; or the lymphatic system may also allow the venom to be carried systemically.

This damage to muscle cells may cause rhabdomyolysis , respiratory muscle compromise, or both. The toxins cause direct damage to the glomeruli in the kidneys as well as causing protein deposits in Bowman's capsule.

Or the kidneys may be indirectly damaged by envenomation due to shock, clearance of toxic substances such as immune complexes, blood degradation products or products of muscle breakdown rhabdomyolysis. In venom-induced consumption coagulopathy , toxins in snake venom promote hemorrhage via activation, consumption and subsequent depletion of clotting factors in the blood.

Toxins in snake venom especially the venom of new world pit vipers the family crotalina may also cause low platelets thrombocytopenia or altered platelet function also leading to bleeding.

Snake venom is known to cause neuromuscular paralysis, usually as a flaccid paralysis that is descending; starting at the facial muscles, causing ptosis or drooping eyelids and dysarthria or poor articulation of speech, and descending to the respiratory muscles causing respiratory compromise.

The strength of venom differs markedly between species and even more so between families, as measured by median lethal dose LD 50 in mice. Subcutaneous LD 50 varies by over fold within elapids and by more than fold in vipers.

The amount of venom produced also differs among species, with the Gaboon viper able to potentially deliver from to milligrams of venom in a single bite, the most of any snake. Snakes are most likely to bite when they feel threatened, are startled, are provoked, or when they have been cornered. Snakes are likely to approach residential areas when attracted by prey, such as rodents.

Regular pest control can reduce the threat of snakes considerably. It is beneficial to know the species of snake that are common in local areas, or while travelling or hiking. Africa , Australia , the Neotropics , and South Asia in particular are populated by many dangerous species of snake.

Being aware of—and ultimately avoiding—areas known to be heavily populated by dangerous snakes is strongly recommended. When in the wilderness, treading heavily creates ground vibrations and noise, which will often cause snakes to flee from the area.

However, this generally only applies to vipers, as some larger and more aggressive snakes in other parts of the world, such as mambas and cobras , [43] will respond more aggressively. If presented with a direct encounter, it is best to remain silent and motionless.

If the snake has not yet fled, it is important to step away slowly and cautiously. The use of a flashlight when engaged in camping activities, such as gathering firewood at night, can be helpful. Snakes may also be unusually active during especially warm nights when ambient temperatures exceed 21 °C 70 °F.

It is advised not to reach blindly into hollow logs, flip over large rocks, and enter old cabins or other potential snake hiding-places. When rock climbing , it is not safe to grab ledges or crevices without examining them first, as snakes are cold-blooded and often sunbathe atop rock ledges.

In the United States, more than 40 percent of people bitten by snakes intentionally put themselves in harm's way by attempting to capture wild snakes or by carelessly handling their dangerous pets—40 percent of that number had a blood alcohol level of 0. It is also important to avoid snakes that appear to be dead , as some species will actually roll over on their backs and stick out their tongue to fool potential threats.

A snake's detached head can immediately act by reflex and potentially bite. The induced bite can be just as severe as that of a live snake.

It may be difficult to determine if a bite by any species of snake is life-threatening. A bite by a North American copperhead on the ankle is usually a moderate injury to a healthy adult, but a bite to a child's abdomen or face by the same snake may be fatal.

The outcome of all snakebites depends on a multitude of factors: the type of snake, the size, physical condition, and temperature of the snake, the age and physical condition of the person, the area and tissue bitten e.

Identification of the snake is important in planning treatment in certain areas of the world, but is not always possible. Ideally the dead snake would be brought in with the person, but in areas where snake bite is more common, local knowledge may be sufficient to recognize the snake.

However, in regions where polyvalent antivenoms are available, such as North America, identification of snake is not a high priority item. Attempting to catch or kill the offending snake also puts one at risk for re-envenomation or creating a second person bitten, and generally is not recommended.

The three types of venomous snakes that cause the majority of major clinical problems are vipers , kraits , and cobras. Knowledge of what species are present locally can be crucial, as is knowledge of typical signs and symptoms of envenomation by each type of snake.

A scoring system can be used to try to determine the biting snake based on clinical features, [51] but these scoring systems are extremely specific to particular geographical areas and might be compromised by the presence of escaped or released non-native species.

Snakebite first aid recommendations vary, in part because different snakes have different types of venom. Some have little local effect, but life-threatening systemic effects, in which case containing the venom in the region of the bite by pressure immobilization is desirable.

Other venoms instigate localized tissue damage around the bitten area, and immobilization may increase the severity of the damage in this area, but also reduce the total area affected; whether this trade-off is desirable remains a point of controversy.

Because snakes vary from one country to another, first aid methods also vary. Many organizations, including the American Medical Association and American Red Cross , recommend washing the bite with soap and water. Australian recommendations for snake bite treatment recommend against cleaning the wound.

This speeds determination of which antivenom to administer in the emergency room. As of , clinical evidence for pressure immobilization via the use of an elastic bandage is limited. The object of pressure immobilization is to contain venom within a bitten limb and prevent it from moving through the lymphatic system to the vital organs.

This therapy has two components: pressure to prevent lymphatic drainage, and immobilization of the bitten limb to prevent the pumping action of the skeletal muscles.

Until the advent of antivenom , bites from some species of snake were almost universally fatal. The first antivenom was developed in by French physician Albert Calmette for the treatment of Indian cobra bites.

Antivenom is made by injecting a small amount of venom into an animal usually a horse or sheep to initiate an immune system response. The resulting antibodies are then harvested from the animal's blood. Antivenom is injected into the person intravenously , and works by binding to and neutralizing venom enzymes.

It cannot undo damage already caused by venom, so antivenom treatment should be sought as soon as possible. Modern antivenoms are usually polyvalent, making them effective against the venom of numerous snake species.

Pharmaceutical companies which produce antivenom target their products against the species native to a particular area. Although some people may develop serious adverse reactions to antivenom, such as anaphylaxis , in emergency situations this is usually treatable and hence the benefit outweighs the potential consequences of not using antivenom.

Giving adrenaline epinephrine to prevent adverse reactions to antivenom before they occur might be reasonable in cases where they occur commonly. Chronic health effects of snakebite include but is not limited to non-healing and chronic ulcers, musculoskeletal disorders, amputations, chronic kidney disease, and other neurological and endocrine complications.

The following treatments, while once recommended, are considered of no use or harmful, including tourniquets, incisions, suction, application of cold, and application of electricity. In extreme cases, in remote areas, all of these misguided attempts at treatment have resulted in injuries far worse than an otherwise mild to moderate snakebite.

In worst-case scenarios, thoroughly constricting tourniquets have been applied to bitten limbs, completely shutting off blood flow to the area. By the time the person finally reached appropriate medical facilities their limbs had to be amputated.

Several new drugs and treatments are under development for snakebite. Earlier estimates for snakebite vary from 1. Most snakebites are caused by non-venomous snakes. Worldwide, snakebites occur most frequently in the summer season when snakes are active and humans are outdoors.

When venomous snakes bite a target, they secrete venom through their venom delivery system. The venom delivery system generally consists of two venom glands, a compressor muscle, venom ducts, a fang sheath, and fangs. The primary and accessory venom glands store the venom quantities required during envenomation.

The compressor muscle contracts during bites to increase the pressure throughout the venom delivery system. The pressurized venom travels through the primary venom duct to the secondary venom duct that leads down through the fang sheath and fang.

The venom is then expelled through the exit orifice of the fang. The total volume and flow rate of venom administered into a target varies widely, sometimes as much as an order of magnitude. One of the largest factors is snake species and size, larger snakes have been shown to administer larger quantities of venom.

Snake bites are classified as either predatory or defensive in nature. During defensive strikes, the rate of venom expulsion and total volume of venom expelled is much greater than during predatory strikes. Defensive strikes can have 10 times as much venom volume expelled at 8.

While employing similar venom expulsion mechanics, predatory strikes are quite different from defensive strikes. Snakes usually release the prey shortly after the envenomation allowing the prey to run away and die. Releasing prey prevents retaliatory damage to the snake. The venom scent allows the snake to relocate the prey once it is deceased.

This is an important skill as venom is a metabolically expensive resource. Venom metering is the ability of a snake to have neurological control over the amount of venom released into a target during a strike based on situational cues. This ability would prove useful as venom is a limited resource, larger animals are less susceptible to the effects of venom, and various situations require different levels of force.

There is a lot of evidence to support the venom metering hypothesis. For example, snakes frequently use more venom during defensive strikes, administer more venom to larger prey, and are capable of dry biting.

A dry bite is a bite from a venomous snake that results in very little or no venom expulsion, leaving the target asymptomatic. The alternative to venom metering is the pressure balance hypothesis.

The pressure balance hypothesis cites the retraction of the fang sheath as the many mechanism for producing outward venom flow from the venom delivery system. When isolated, fang sheath retraction has experimentally been shown to induce very high pressures in the venom delivery system. It was determined that the pressure created from the fang sheath retraction was at times an order of magnitude greater than those created by the compressor musculature.

Snakes do not have direct neurological control of the fang sheath, it can only be retracted as the fangs enter a target and the target's skin and body provide substantial resistance to retract the sheath. For these reasons, the pressure balance hypothesis concludes that external factors, mainly the bite and physical mechanics, are responsible for the quantity of venom expelled.

Venom spitting is another venom delivery method that is unique to some Asiatic and African cobras. In venom spitting, a stream of venom is propelled at very high pressures outwards up to 3 meters. The venom stream is usually aimed at the eyes and face of the target as a deterrent for predators.

There are non-spitting cobras that provide useful information on the unique mechanics behind venom spitting. Unlike the elongated oval shaped exit orifices of non-spitting cobras, spitting cobras have circular exit orifice at their fang tips.

Snakes were both revered and worshipped and feared by early civilizations. The ancient Egyptians recorded prescribed treatments for snakebites as early as the Thirteenth Dynasty in the Brooklyn Papyrus , which includes at least seven venomous species common to the region today, such as the horned vipers.

The object was regarded as a divinely empowered instrument of God that could bring healing to Jews bitten by venomous snakes while they were wandering in the desert after their exodus from Egypt. Healing was said to occur by merely looking at the object as it was held up by Moses.

Historically, snakebites were seen as a means of execution in some cultures. Snakebite as a surreptitious form of murder has been featured in stories such as Sir Arthur Conan Doyle 's The Adventure of the Speckled Band , but actual occurrences are virtually unheard of, with only a few documented cases.

At least one attempted suicide by snakebite has been documented in medical literature involving a puff adder bite to the hand. In , the World Health Organization listed snakebite envenoming as a neglected tropical disease.

Key institutions conducting snakebite research on snakebite are George Institute for Global Health, Liverpool School of Tropical Medicine and Indian Institute of Science. Several animals acquired immunity against venom of snakes that occur in the same habitat.

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See also: List of dangerous snakes. Main articles: Snake venom and Venom-induced consumption coagulopathy. Further information: Pressure immobilization technique. Main article: Epidemiology of snakebites. See also: List of fatal snake bites in the United States and List of fatal snake bites in Australia.

See also: Envenomation. See also: Serpent symbolism. National Institute for Occupational Safety and Health. Archived from the original on 29 April Retrieved 19 May The New England Journal of Medicine.

doi : PMID World Health Organization. February Archived from the original on 4 May December Archived from the original on 30 September Rosen's emergency medicine: concepts and clinical practice 7 ed.

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New York, NY: McGraw Hill; Update date: 27 February Updated by: Stephen C. Acosta, MD, Department of Emergency Medicine, Portland VA Medical Center, Portland, OR. Review provided by VeriMed Healthcare Network.

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Clinical Toxicology. eMedicine Health. If unavailable, bottled water is acceptable. Leave contaminated wounds, bites, and punctures open. Wounds that are sutured in an unsterile environment, or are not cleansed, irrigated, and debrided appropriately, are at high risk for infection due to contamination.

Wounds that are not closed primarily because of high risk of infection should be considered for delayed primary closure by experienced medical staff using sterile technique.

Remove devitalized tissue and foreign bodies prior to repair as they may increase the incidence of infection. Clip hair close to the wound, if necessary. Shaving of hair is not necessary, and may increase the chance of wound infection. Cover wounds with dry dressing; deeper wounds may require packing with saline soaked gauze and subsequent coverage with a dry bulky dressing.

Follow tetanus prophylaxis guidelines for all wounded patients. Follow tetanus prevention guidelines.

Other Considerations Be vigilant for the presence of other injuries in patients with any wounds. Ensure adequate referral, follow-ups, and reevaluations whenever possible.

Dirty water and soil and sand can cause infection. Wounds can become contaminated by even very tiny amounts of dirt. Puncture wounds can carry bits of clothing and debris into wound resulting in infection. Crush injuries are more susceptible to infection than wounds from shearing forces.

Guidance for Management of Wound Infections Most wound infections are due to staphylococci and streptococci. and clindamycin are recommended options.

Of note, recently an increasing number of community associated skin and soft tissue infections appear to be caused by methicillin-resistant Staphylococcus aureus MRSA.

Infections caused by this organism will not respond to treatment with beta-lactam antibiotics and should be considered in patients who fail to respond to this therapy.

Treatment options for these community MRSA infections include trimethoprim-sulfamethoxazole oral or vancomycin intravenous. Clindamycin is also a potential option, but not all isolates are susceptible.

Incision and drainage of any subcutaneous collections of pus abscesses is also an important component of treating wound infections. Special Considerations Related to Contamination of Wounds by Water Contamination of wounds with water fresh or sea water can lead to infections caused by waterborne organisms.

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While most snakes in the U. are not venomous, several types do contain venom. In the U. Pit vipers are distinguishable by a noticeable depression between the eye and nostril.

This pit is the heat-sensing area for the snake. While all pit vipers have a triangular head, not all snakes with a triangular head are venomous.

If you or someone you are with has been bitten by a snake, you will know immediately. Rattlesnakes are easily identifiable. They have rings at the end of their tails that shake when they feel threatened.

This makes a rattling sound and is a warning for you to back away. Rattlesnakes are the largest of the venomous snakes and account for many of the venomous bites in the U. each year. These snakes can be found in nearly any habitat across the country. They like open areas where they can rest in the sun such as rocks, and logs.

The water moccasin is another type of pit viper. This snake is also known as a cottonmouth, because the inside of its mouth is lined with a white, cottony material. Adults have dark tan to black skin with faint dark brown or black crossbands.

Young snakes have brown or orange crossbands with a yellow tail. These snakes are found in the southeastern states, usually in or near water.

Copperheads are reddish or gold in color with hourglass-shaped bands. This snake is typically 18 to 36 inches in length. Copperheads are mostly found in forests, swamps, rocky areas, and rivers in the eastern states as far as Texas. They are not aggressive. Most copperhead bites occur if you accidentally step on or near one.

Coral snakes have black, yellow, and red banding and are often confused with non-venomous king snakes. You can distinguish a coral snake by the fact that the red bands touch the yellow bands. They live in the woods, marshes, and sandy areas of the South. Coral snakes typically hide underground and in leaf piles.

However, there are some tips that you should also keep in mind:. There are also several outdated first aid techniques that are now believed to be unhelpful or even harmful:.

The most important thing to do for a snake bite is to get emergency medical help as soon as possible. A doctor will evaluate the victim to decide on a specific course of treatment.

In some cases, a bite from a venomous snake is not life-threatening. The severity depends on the location of the bite and the age and health of the victim. If the bite is not serious, the doctor may simply clean the wound and give the victim a tetanus vaccine. If the situation is life threatening, the doctor may administer antivenom.

This is a substance created with snake venom to counter the snake bite symptoms. The sooner the antivenom is used, the more effective it will be. The outlook for a person with a snake bite is highly variable.

For a non-venomous snake bite, the outlook is excellent if the wound is cleaned and treated promptly. For a venomous bite, the outlook is good if the victim receives emergency care very soon after the bite has occurred.

Healthy adults with shallow bites have a better outlook than children and those with weakened immune systems who have received deep bites. Snake bites can be prevented in many cases. Avoid typical places where snakes like to hide, such as patches of tall grass and piled leaves, and rock and woodpiles.

If you encounter a snake, give it space to retreat and let it take cover. When working outside where snakes may be present, wear tall boots, long pants, and leather gloves. Avoid working outside during the night and in warmer weather, which is when snakes are most active. Learn about rattlesnake bites, including how to treat them and the expected timeline.

Tetanus, also called Lockjaw, is a serious bacterial infection that affects the nervous system and causes muscles throughout the body to tighten. A honey bee sting usually just causes temporary pain.

Know appropriate first aid for treating snake bites. First aid for snake bites If you are unlucky enough to be bitten, here is what you should and should not do. Assume ALL snakes are venomous, and take the following action: Do not panic.

Try to remain calm, lie down and immobilise the bitten area. It is unlikely that the bite will be life-threatening. Apply a bandage but do not block circulation. Take a broad bandage and bind along the limb starting at the bite area, at the same pressure as for a sprain.

Then bandage down the limb and continue back up the entire limb over and above the bite area. This will help prevent the spread of the venom through the body. Do not remove the bandage. It is often easier to go over the top of clothing such as jeans rather than remove clothing.

In an emergency, strips of clothing or pantyhose can be used instead of a bandage. Immobilise the limb with a splint. Lie down and keep the limb completely still until help arrives. Do not elevate the limb or attempt to walk or run.

Movement will encourage the spread of the venom through the body. Do not attempt to catch the snake. All too often, the snake will bite again if an attempt is made to catch it. Identification of the snake species can be obtained through samples of the patient's blood or urine, and from venom around the bite area.

If the species of snake still remains uncertain, a poly-antivenene may be used, which is suitable for treatment of all venomous snake bites.

Do not wash the wound. Venom left on the skin will help doctors identify the snake and administer the appropriate antivenene. Do not cut the wound. This will spread the venom into the bloodstream and can cause more serious injuries than the snake bite itself.

Seek medical help. An antivenene may be required. Last reviewed 15 June Last updated 6 June Page feedback.