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JAMA Patient Page
April 18, 2012

Snakebite

JAMA. 2012;307(15):1657. doi:10.1001/jama.2012.433

Many types of snakes exist in all parts of the world and live in close quarters with humans. More than 20 000 persons worldwide die of snakebites every year. Many snakebite injuries are preventable with greater education about snakes and how to avoid them. A snakebite is a medical emergency.

TYPES OF SNAKEBITES

Venomous (poisonous) snakes deliver dangerous poison when they bite their prey. Not every snakebite from a poisonous snake results in venom being delivered, but it is always a possibility. Nonvenomous snakes (those that are not poisonous) also bite, but their bites do not inject venom into the wound. Envenomation is the release of snake venom into the prey's or person's body. Venomous snakes use fangs to inject their venom; these fangs often leave 1 or 2 puncture marks when a person is bitten. Nonvenomous snakebites usually result in a semicircular pattern that looks like a large smile on the skin's surface.

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TREATMENT

  • Seek medical attention immediately after a snakebite.

  • Try to remember the shape of the snake's head and body and the snake's color to identify the type of snake and help direct the treatment. A photo, taken from a safe distance, may be helpful.

  • Keep calm and move around as little as possible. This may limit the spread of the snake's venom. Remove anything that may constrict the area, such as jewelry, clothing, or shoes.

  • Do not use tourniquets or suction devices. Do not cut the area around the bite. These traditional remedies do not help and they may harm the patient, making the situation much worse.

  • A tetanus immunization may be given if you have not had one recently.

  • Antivenin, specific to the type of snake responsible for the bite, may be given in case of severe envenomation. This helps neutralize the effect of snake venom in life-threatening or limb-threatening snakebites.

  • Persons with severe symptoms (rapid heartbeat, difficulty breathing, severe swelling, low blood pressure, severe external or internal bleeding, paralysis, circulatory shock or collapse) may require supportive care, including oral or intravenous fluids, medications, or breathing treatments. Intensive care and life support may be needed for the most severe cases of snakebite, especially in small children or elderly persons.

AVOIDING SNAKEBITES

  • Wear long pants and boots when walking or working in tall grass, the woods, or known snake habitats.

  • Do not use your hands to move wood or leaves in piles.

  • Be aware of snakes that live in or near water.

  • If you see a snake, let it pass. Move slowly backward away from the snake.

  • Do not approach a snake or try to handle it even if it appears dead; many snakebite injuries occur because individuals touch or bother a snake.

  • Teach children to avoid snakes and their habitats. Because of their smaller body size, children are more likely to have a severe reaction if envenomation happens during a snakebite.

FOR MORE INFORMATION

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA 's website at www.jama.com. Many are available in English and Spanish.

Sources: World Health Organization, American College of Emergency Physicians, American Academy of Family Physicians, National Safety Council

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Topic: EMERGENCY CARE

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