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The Duel Trail Race

Snakebite First Aid on the Trails – Do’s, Don’ts, and Dry Bites

Scenario: You’re running out at Hill Country State Natural Area training for the Cactus Rose 100. You’re on the sotol torture trail near the Three Sisters when your left foot lands on this guy.

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Or it could have been this guy.

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Or this guy.

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It was hard to tell what brand he was because as soon he bit through your minimalist trail shoe, he disappeared under the sotol.

You should:

A. Pull out your snake bite kit and suck the venom out
B. Fashion a constricting band out of your shoelace and tie it above the bite
C. Run back to the car and get ice out of your cooler and put it on the bite
D. Pull out your cell phone and call 911
E. Finish your training run, it was probably a dry bite and you need the miles

Instructor Key:

A. Pull out your snake bite kit and suck the venom out

Nope. The Saywer Extractor will not suck any venom out of a snake bite. Spend your $17 on something else at REI.

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“At least three studies, done independently of each other and using different methodologies, arrived at the same conclusion-that the Extractor does not work for venomous snakebites and could make things worse.” This is from Paul S. Auerbach’s wilderness medicine bible, Wilderness Medicine. The Wilderness Medicine Institute also recommends against the use of extractors for snake bites. (They can be used to make fun hickey marks though.)

B. Fashion a constricting band out of your shoelace and tie it above the bite

Nope. Not for North American pit vipers. Our vipers here in North America — the rattlesnakes, copperheads, and cottonmouths/water moccasins — have a tissue destroying venom that can do more damage when it’s confined to one area with a constricting band or a tourniquet.

The limb should be immobilized. So stop running and sit or lie down.

C. Run back to the car and get ice out of your cooler and put it on the bite

Nope. First, running is just going to circulate the venom around your body more quickly. Try to keep your heart rate low by sitting still and staying calm.

Second, ice isn’t helpful. The venom can cause all sorts of vascular damage and you don’t want to do anything that would reduce blood flow to the affected tissue further. Cold can make the injury worse. So save the ice to keep the beer cold. And put your taser away. Electrotherapy will only add insult to injury.

D. Pull out your cell phone and call 911

Yup. Actually, pull out your phone and try and call the park headquarters. You’ll receive aid more quickly if your call goes directly to the rangers who have the means and know-how to get to you. Don’t know the local park headquarters’ number? Put it in your phone. Can’t get through to anybody when you call? Then call 911.

No cell reception? Have your running buddy run for help.

No running buddy? Get one.

You’re on your own because you like the solitude, you have no cell reception, and you got bitten by a snake? Dang. Walk slowly and calmly to the closest place with people. Blowing a rescue whistle is a nice way to attract attention to yourself.

E. Finish your training run, it was probably a dry bite and you need the miles

While at least a quarter of snake bites are dry and no venom is injected, and the Cactus Rose belt buckle is particularly nice, go ahead and call it a day and sit down and phone for help. And don’t let any of your running buddies try to hunt down the snake while you wait. They’ll probably just get themselves bitten and it’s not necessary to know exactly what the kind of snake it was.

Scenario continued:

You walk slowly to a clear spot, sit down, pull your phone out of your hydration pack and call the park. You look at the fang marks and notice that your foot has begun to swell.

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It’s beginning to hurt more too. You wonder if you’re going to die and whether you should take your calf sleeves off.

Unlikely and yes.

7000-8000 people get bitten by venomous snakes each year in the United States. About five of those people die according to the CDC. So you’re probably not going to die from this bite.

You may experience some really unpleasant signs and symptoms though including:

  • Swelling and pain
  • Bruising and blister formation and later tissue death (There are all sorts of unsettling images online of these particular signs.)
  • Weakness, sweating, chills
  • Nausea and maybe vomiting
  • Numbness and swollen lymph nodes

Since you don’t know how severe the envenomation is, you must go to the hospital immediately. You will be treated with antivenin there if necessary.

The calf sleeve and any jewelry around the bite needs to be removed. It will act like a tourniquet as the affected area continues to swell.

End of the story:

The swelling has progressed halfway up your calf when the rangers arrive and carry you down to their ATV. You express your hatred for snakes on the ride to the ranger station where an ambulance is waiting for you. Ranger Niki reminds you that you stepped on the snake and that it was just protecting itself. She starts to tell you how North American snakes are not aggressive (Feel free to send me your “I Was Chased by a Water Moccasin” stories), but sees the look on your face and thinks better of it. You are given antivenin in the hospital and discharged after two days. You PR at Cactus Rose in October.

But wait, what about this guy? The coral snake.

We’re all familiar with its red-yellow band pattern. Red on yellow, kill a fellow. Red on black, venom lack. Interestingly the rhyme doesn’t work with South American coral snakes. Venomous coral snakes in South America can have red-black band patterns.

So, close to the Mexican border, use this rhyme: It’s a snake, don’t touch it.

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You really have to work hard to get yourself bitten by a coral snake.

Read this story about the first coral snake death in the US since 1967 to see how hard you have to work - http://www.naplesnews.com/news/2006/jun/13/man_dies_snake_bite/. The first two paragraphs are beautiful.

If you do manage to get yourself bitten, (I’m talking to you, you white males in your 20s who are drunk and want to play with snakes.) the symptoms will be different, but the treatment will be the same. Stay calm. Keep the affected body part still. Call for help. A pressure bandage can also be used over a coral snake bite because the venom is a neurotoxin. But again, you’re wildly unlikely to get bitten by this snake, so I’d focus on remembering the “It’s a snake, don’t touch it” bit.

Please let me know what questions you have. And, if any of you have been bitten by a snake while running, please share your story.

- Liza Howard

About the author

Liza Howard Liza Howard became addicted to ultra running belt buckles back in 2008 and now runs for New Balance and coaches fellow ultra runners. She also teaches for the Wilderness Medicine Institute and is a field instructor for the National Outdoor Leadership School. For more information on Liza, check out the About page where you can learn about her coaching, trail running camp, and daily life musings.

19 Responses to “Snakebite First Aid on the Trails – Do’s, Don’ts, and Dry Bites”

  1. on 10 Jun 2013 at 1:15 pm olga

    I always follow “If it’s a snake don’t touch it – go away, far, far away!”.:)

  2. on 10 Jun 2013 at 2:00 pm Amanda

    Thank you so much for this! I was struck at once by a rattler, but not bitten. I’ve been trying to come up with an action plan in case of a snake bite ever since and this is perfect. I had thought of whistles, but didn’t think about contacting the rangers first. Great advice!

  3. on 10 Jun 2013 at 3:33 pm Brian

    Thanks for the insight, Liza. Great piece: well-written and informative. I hope I never have to follow your advice!

  4. on 10 Jun 2013 at 3:41 pm olga

    Well, it’s because I always run alone, don’t carry a cell phone, and even if I did, I wouldn’t put ranger’s number (and wouldn’t even care to figure out where to find one), don’t have a whistle, and, well, have a bad lackadaisical attitude. But at least I learned a few things: don’t panic – I won’t die, and crawl SLOWLY to people.

  5. on 10 Jun 2013 at 5:09 pm Rafael Marquez

    I’ve seen plenty of snakes on trail but have never been bitten by one. I knew that I should formulate a plan of somekind, but until I read this article I hadn’t bothered. Thank you for the insight!

  6. on 10 Jun 2013 at 7:36 pm Donna

    Informative and entertaining article! You clearly understand how runners think.

  7. on 10 Jun 2013 at 8:09 pm Richard

    The rattlesnake pictured looks an awful lot like a Mojave rattlesnake (Crotalus scutulatus), which has venom that neurotoxic as well as hemotoxic. They’re also regarded as having a nasty disposition and more prone to be “aggressively defensive” than most other rattlers. Put this one at the top of your list of snakes not to touch.

  8. on 10 Jun 2013 at 8:32 pm Perry Reid

    What about snake proof boots or shaps?

  9. on 10 Jun 2013 at 10:01 pm Ben

    That’s it!!! I’m running cr in boots & chaps!!!

  10. on 11 Jun 2013 at 6:07 am Daily News, Tues, June 11

    [...] Snakebite first aid on the trails.  My good friend lost his arm to a rattler while he was on a run, so while it’s rare, they will get ya. [...]

  11. on 11 Jun 2013 at 7:09 am Victoria

    Some pit vipers especially in west Texas and other areas of the Southwestern US have been know to pierce through some extensive material. I wouldn’t rely purely on the chaps. :)

    Aren’t those snakes awesome!

  12. on 11 Jun 2013 at 12:04 pm CharlieG

    http://www.gadailynews.com/news/national/157124-alabama-hunter-chad-cross-saves-own-life-after-rattlesnake-bit-him.html

  13. on 11 Jun 2013 at 6:46 pm Herpetologist

    Excellent, article, Liza. Spot on.

    @Richard: nope, the snake pictured is a Western Diamondback.

  14. on 12 Jun 2013 at 7:47 am Liz

    I never hit my trails in the Sierra Mountains without my SPOT!! This was very helpful info thank you :)

  15. on 12 Jun 2013 at 11:58 am Carl Weil

    Gorkey makes snake proof boots and gaiters which could be used with running shoes

    Mojave green is neurotoxin as well. Cost of treatment with antivenin is now average over $100,000

    hiking with trekking poles is good as snake may strike poles

    For those of us who are not city dwellers – self evacuation to a hospital that carries antivenin is critical and few hospitals carry antivenin at $2,000 a vial with 25 vials average treatment

  16. [...] few days.  If you haven’t seen my little snake bite first aid piece yet on Endurance Buzz, here it is.  I got good comments from [...]

  17. on 24 Mar 2014 at 7:25 am Daily News, Mon, Mar 24

    […] are starting to come out here in California. Here’s some snake bite First Aid for the trail. (And on a personal level, my long time XC coach lost his arm to a Rattler on a run, so it does […]

  18. on 16 Apr 2014 at 12:36 pm Arlene

    The few rattlers that I have met, even while trail running, have given me good warning to avoid them. Good advice to carry a whistle and cell phone with ranger contact numbers and hopefully, you have cell coverage. Our teaching in Wilderness First Aid nixes venom extraction and/or tourniquets. DO be with at least two other folks in case of emergency.

  19. on 10 Aug 2014 at 5:00 pm Rickey

    My lab got bitten 7 times in the front legs and chest area by a copper head several years ago. By the time I got home to him, he would get up really shaky and fall back to the floor. I took my chain saw and put a long piece of spark plug cable that I had into the end of the spark plug lead on the chain saw. I put the other end of the cable in his mouth at his right jaw. I pulled the starter rope and it shocked him a few times. I then put the cable in his mouth at his left jaw and repeated the process. An hour and a half later he was up, another hour passed and he was playing. I called the vet the next morning and told him what happened and what I did. He said that was the best thing I could have done and to just watch for infection, if he developed any I should bring him in for antibiotic shots. He did not develop any infections but after that he was the best snake killing dog I have ever seen.

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