Prior, on ticks and Lyme disease.

Summer is here, and with it, four-legged critters, but they aren’t the only things in the woods that can harm you. The thing about snakes is they can be just about anywhere when it’s warm.

Important factoid: Most snake bites are strikes to the hand; check the area before working or grabbing things.

Source:

Please allow me to introduce myself. I am a medical toxicologist and emergency physician at Baylor College of Medicine in Houston, Texas. I have treated 600+ snakebites and direct one of the busiest snakebite services in the U.S.

I also love snakes and consider myself a member of the herpetology community. And I want to help prevent any bad outcomes (for both humans and snakes) if a snake-human interaction goes awry.

I hate snakes, especially Cotton Mouth Moccasins which can range widely in color and markings.

These are the recommendations for pre-hospital treatment. I will have a different post dealing with hospital management.

Found at the link: Snakebite Management (in hospital) – Pit Vipers.

If you get bitten by a snake you suspect is (or may be) venomous:

1. Get away from the snake. No need to hurt the snake just because you’re angry, and you don’t want to incur additional injury.

 

2. If you (or someone else) can safely and quickly get a picture of the snake, great, but don’t waste time or risk a second envenomation. Ultimately, pit viper (rattlesnakes, copperheads, cottonmouths/water moccasins) envenomations are diagnosed clinically. As are coral snake bites, but most people can identify those. Just pray you have a doctor who knows what he or she is doing (see below)

If you can take a picture, you can shoot it first. Just sayin’. Pro tip: birdshot in .410 for a handgun. Outdoor Life lists several options with pros and cons for each. It may be illegal to kill snakes in your area; 3S treatments may apply.

3. Remove constrictive clothing and jewelry

4. Position the affected extremity appropriately. This is a little controversial, but some things are clear. For pit viper bites (which account for > 95% of the venomous snakebites in the U.S.), DO NOT PLACE BELOW HEART LEVEL. Almost all pit viper bites cause local tissue injury, and placing the affected extremity below heart level will cause the venom to collect in the extremity and will increase the hydrostatic pressures in the extremity. This will increase the potential damage to lymphatic vessels and increase the likelihood of some degree of permanent injury, such as post-exertional swelling. For copperhead and cottonmouth bites, in which local tissue is highly likely but the likelihood of systemic toxicity is low, I recommend placing the affected extremity ABOVE HEART LEVEL. In rattlesnake bites, it is reasonable to keep the affected extremity AT HEART LEVEL.These variations are for pre-hospital management. Once in the hospital, the affected extremity should always be elevated. This is emphasized in the unified treatment algorithm.

5. Get to an appropriate hospital. If you are having life-threatening signs and symptoms (e.g. airway issues, low blood pressure) get to the closest hospital for stabilization. They can then transfer you if needed to an expert. Otherwise, proceed directly to a hospital with a snakebite expert. If you interact with snakes a lot or are outside in snake-endemic areas, you should investigate your regional hospitals to locate one or more specialists. I can help you with this. It’s a pretty small community.

6. Avoid dangerous and/or stupid interventions:

• DO NOT cut and suck. All this does is make a wound worse and potentially introduces bacteria into the wound

1. • DO NOT apply a tourniquet. There is no benefit in cutting off an extremity’s arterial blood supply unless the patient is bleeding to death.
   • DO NOT apply any sort of constriction band or pressure immobilization for pit vipers. For the same reason that we do not place the affected extremity below heart level. The American College of Medical Toxicology has a position statement on this.
   • Pressure immobilization IS reasonable for coral snake bites.
   • DO NOT use electrical shock treatment. It does not “neutralize the venom” or whatever nonsense advocates claim. But it is a good way to cause permanent injury.
   • DO NOT apply heat.
   • DO NOT apply PROLONGED icepacks. A few minutes at a time is okay (say, 5 minutes on, 10 minutes off) but prolonged cryotherapy is bad for the tissue.

7. DO NOT use one of those commercially-available suctions devices. They don’t remove venom. They just suck. See the best-titled editorial ever here.Do not bring the snake to the hospital. A dead snake can still envenomate you, and I hate when people kill snakes. And as much as I like snakes, I do acknowledge it becomes a logistical difficulty when someone brings a live snake to the ED. And, as I said before, we don’t need to see the snake to provide appropriate treatment.

I love when people kill snakes.

Summer is fast approaching and with it four-legged critters become more of a threat to humans but they aren’t the only thing in the woods that can harm you.

In our last article, we discussed general aspects of those tiny but problematic arachnids: ticks. Perhaps the most well-known disease transmitted by ticks is Lyme Disease.

Spring and Fall are seasons that ticks are commonly known to bite humans. The most well-known disease passed by ticks to humans is known as “Lyme disease.” Lyme disease was unknown until about 1975, where it was first diagnosed in the town of Old Lyme, Connecticut. Since then, Lyme has become the most common tick-borne illness in the Northern Hemisphere, so common that May is officially Lyme Disease Awareness Month.

Lyme Disease is caused by the corkscrew-shaped bacterium known as Borrelia burgdorferi. Another species, Borrelia mayonii, has also been shown to also cause the disease. Both are carried by Ixodes scapularis, also known as the blacklegged or deer tick, in the East, upper Midwest, and all the way down south to Texas. The western blacklegged tick (Ixodes pacificus) can be found all along the Pacific coast. Ticks are responsible for more than Lyme disease; they’re also responsible for transmitting babesiosis, anaplasmosis, and other infections.

In settings where winters are milder and acorns abundant, the population of animals that ticks like to feed upon increases. These include mice, a favorite of baby ticks, and deer, popular targets for adults. The Centers for Disease Control and Prevention (CDC) are estimating many tens of thousands of Lyme cases in humans per year (three times the number reported 20 years ago).

One time while hiking, I picked up nine ticks. As I approached a shoulder-high grassy field, I thought better of entering it for several reasons, but the whole hike, something about the place was deeply bothering me. There are places in Tennessee where you should only go if you live there. Even the people who grow up here know that if it seems like a place you shouldn’t be, well, you shouldn’t. I only hiked a bit and stayed on a known trail, but somehow, I was covered in the American Dog Tick (Wood Tick). Nasty creatures, and a very disappointing hike as I wanted to establish knowledge of the area. I entered the area previously from the other end of the trail, went so far, and wanted to see the rest of the route on a single-day venture by entering from the other end. The lesson was, that area would not fit within the purposes I needed; maybe it was a success after all.

The article covers prevention, symptoms, treatments, and other tick-borne diseases.

From a reader, Fox News:

James Jordan, 30, of West Yarmouth, Mass., was arrested early Saturday on a federal complaint charging him with murder and assault with intent to murder in connection with the “senseless and brutal attack” on the two unidentified hikers, Abingdon U.S. Attorney Thomas Cullen said.

Jordan was known to hike the Appalachian Trail under the moniker “Sovereign,” WCYB-TV reported. He was arrested in April for threatening hikers on the Appalachian Trail in Tennessee, pleaded guilty and was sentenced to probation, according to WJHL-TV.

The victims were hiking together when they were attacked, WSLS-TV reported. Deputies responded sometime after 3:30 a.m.

The deputies used GPS to find the man in Wythe County after he sent out an emergency notification on his cellphone, the station reported.

Two hikers helped the woman after she walked six miles injured and bleeding, according to the station.

He looks like a creep, and he isn’t sovereign over anything.  I would had been suspicious of him right off the bat.

When you’re in the bush, there are threats of the four legged kind and two legged kind.  Be prepared for both.  Carry guns and travel with a dog.  Make sure your gun isn’t inside a backpack or stowed away where you can’t get to it.