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First Aid for Twin-Spotted Rattlesnake Bite

Last updated April 29, 2019

Approved by: Maulik P. Purohit MD MPH

jrleszcz

The twin-spotted rattlesnake is a moderately venomous snake that is largely found in higher altitudes among densely vegetated woodlands and oak and pine mountain forests.


IMPORTANT INFORMATION: Read This First

All Snake Bites should be evaluated by a trained medical professional, as early as possible. Failure to obtain prompt evaluation and appropriate treatment may result in severe complications and/or death.

DO NOT WAIT!

Call 911 (within the US) or your local emergency number immediately, if you experienced a Snake Bite.

What is Twin-Spotted Rattlesnake Bite?

  • The twin-spotted rattlesnake is a moderately venomous snake that is largely found in higher altitudes among densely vegetated woodlands and oak and pine mountain forests
  • The snake may average around 2 feet or less in length and has a broad head, slender body that is gray or brown in color with twin rows of spots, and a rattle tail
  • The twin-spotted rattlesnake has been reported from the central and northern parts of Mexico and from a few pockets in Arizona, USA
  • Typically, the snake bites only when provoked or threatened. However, before doing so, it may provide sufficient warning signs to any approaching intruders

Twin-Spotted Rattlesnake Bites usually take place unintentionally or inadvertently, when individuals come in contact with the venomous twin-spotted rattlesnake.

What are the Causes of Twin-Spotted Rattlesnake Bite?

The cause of Twin-Spotted Rattlesnake Bite may include:

  • Residing in areas endemic to the snake
  • Hiking, trekking, or camping in rattlesnake habitat
  • Walking unprotected through forests, bushes, and grasslands; venturing outdoors during the night
  • Amateur study groups and scientific explorers who come into contact with the snakes
  • Keeping them as pets
  • Picking up or handling these rattlesnakes
  • There is a high risk for alcoholics and drug addicts who come into contact with the snakes

What are the Signs and Symptoms of Twin-Spotted Rattlesnake Bite?

The signs and symptoms of a Twin-Spotted Rattlesnake Bite may depend on the quantity of venom injected. It can vary from one individual to another and may be mild or severe. However, in many cases, no significant signs and symptoms are noted.

In case of symptom manifestation, the following initial set of symptoms may be noted:

  • Pain at the bite site, including swelling
  • Bite or fang marks on the affected limb (the fang marks on skin may be one, two, or more)
  • Discoloration of skin and blistering
  • Bleeding from the bite site
  • Metallic taste in the mouth
  • Fatigue and weak muscles
  • Body aches and muscle aches; joint pain
  • Twitching of eye and mouth
  • Tingling sensation and numbness
  • Droopy eyelids or ptosis
  • Chills and sweating
  • Enlarged lymph nodes that may be painful, in some cases
  • Anxiety and drowsiness
  • Nausea, vomiting, and diarrhea

The following signs and symptoms may be observed after several hours:

  • Abdominal pain
  • Blurred vision
  • Poor reflexes
  • Uncontrollable salivation; drooling
  • Breathing difficulties
  • Dark-colored urine
  • Bleeding from the gums, nose, etc.
  • Low blood pressure (hypotension)
  • Tissue necrosis (death), in rare cases
  • Dizziness
  • Unconsciousness

With severe venom injection, a host of systemic symptoms and complications that include cardiovascular instability, neurological symptoms, and kidney failure may be noted in some individuals.

How is First Aid administered for Twin-Spotted Rattlesnake Bite?

If a rattlesnake bite is suspected, it is always important to call your local emergency helpline number (or dial 911 in the US) without any delay, and provide as much information as possible, even if the individual does not have any symptoms. Also, call your local poison control center (US Poison Control Center at 1-800-222-1222) for further instructions.

Until medical help arrives:

  • Remove the individual from the incident spot; move away from the snake immediately
  • Also, move the individual to a shaded area, if he/she is lying exposed to the sun
  • Expose the bite site by removing or cutting the dress material, if necessary
  • Do not immerse the wound in water, but wash it gently with soap and water, if possible. A sterile dry bandage may be used to cover the wound
  • Avoid unnecessary movement (running or walking) and try to keep the victim as comfortable and warm as possible; stay with the victim until help arrives to provide reassurance
  • Make a note of the exact time of the incident and notify the emergency medical personnel accordingly
  • Try to identify or locate the reptile (only if safely possible) and keep the medical personnel informed; if possible, try to take a picture of the snake using one’s mobile phone
  • If the snake is dead, then try to carefully take the snake in a safe container to the healthcare center for identification
  • Use pressure bandage to immobilize the affected site or limb, such that blood circulation is not cut-off; the pressure immobilization technique should be attempted by trained personnel only
  • Remove constrictive clothing and any jewelry, such as bangles, bracelets, wrist watches, and rings, from the limb that is involved, especially before applying pressure immobilization
  • Further a splint (or stick) should be used to prevent the limb joints from bending
  • Avoid anything that can cause an obstruction in the airways
  • DO NOT give anything orally to the individual
  • Unless directed by the physician, DO NOT give any medication
  • Safely transport the affected individual to the nearest and appropriate healthcare facility (having expertise in snakebite treatment, if available)
  • Administer antivenom if available, and ONLY if a qualified healthcare provider is present

The following methods to help the victim SHOULD NOT be allowed or considered:

  • Shaking the affected arm or leg of the bitten individual
  • Forcing the individual to walk long distances (the victim should be carried, as far as possible)
  • Tying constricting bandages above the fang mark
  • Applying ice or pouring other liquids (alcohol) on the bite site
  • Applying heat packs or trying to burn the bite site (applying hot embers)
  • Immersion in hot water or oils
  • Cutting the wound in an attempt to wash away the venom
  • Sucking the bite wound, in an attempt to suck and spit out the venom; or, using any mechanical device to apply suction to the wound
  • Applying topical creams/ointments or any chemicals such as potassium permanganate
  • Giving tea, coffee, or any alcoholic beverages to the victim (water may be given to keep the individual hydrated, if required)
  • Administering ANY form of traditional treatments, use of herbal/native medicines, or other unapproved treatment measures

It is important to note that pressure immobilization bandaging is not the same as providing a tourniquet, which is essentially a constriction of the body part to control blood flow for a certain period of time.

Information on administering antivenom:

  • Administration of antivenom serum (AVS) should be allowed only when there are identifiable signs and symptoms of local and systemic envenomation along with supporting laboratory test evidence
  • At many health centers, the antidote to snake bite envenomation is scarcely available and usually very expensive; thus, it is important to not waste such a life-saving resource
  • Also, in many individuals, there is a high risk for severe allergic reaction, such as anaphylaxis, to the antivenom that may even be fatal
  • Consultation with a medical toxicologist is recommended for all cases requiring anti-snake venom administration

Any indiscriminate use of antivenom serum either due to improper training and knowledge or under compulsion from the victim’s family or friends is therefore highly discouraged. Nevertheless, a qualified healthcare provider is best-placed to determine whether the administration of AVS is necessary or not in each and every specific case.

Who should administer First Aid for Twin-Spotted Rattlesnake Bite?

  • The individual himself/herself or someone nearby may begin administering basic First Aid
  • Call your local emergency helpline number or 911 (within the US) immediately

For all cases involving actual or suspected snake bites, it is very important to immediately seek the advice, evaluation, and treatment of a qualified healthcare provider.

What is the Prognosis of Twin-Spotted Rattlesnake Bite?

The prognosis of Twin-Spotted Rattlesnake Bite is usually dependent on the following set of factors:

  • Venom potency of the subspecies of twin-spotted rattlesnake
  • Site of bite and the amount of toxin injected
  • Age and overall health status of the individual
  • Timely manner in which antivenom is administered
  • Severity of allergic reactions, if any develop
  • Effectiveness of the treatment following admission

In many cases, with urgent first aid, prompt treatment and hospitalization of the victim, the prognosis is typically good. Without treatment or access to proper healthcare, deaths from severe systemic symptoms and complications from Twin-Spotted Rattlesnake Bites may take place (highly uncommon though).

How can Twin-Spotted Rattlesnake Bite be Prevented?

A few helpful tips to prevent snake bites include:

  • Avoid unnecessary contact with any snake; if you spot a snake, try to keep a safe distance between yourself and the snake
  • Completely refrain from touching, provoking, or picking up any snake (even if it is dead)
  • Educate the local community about venomous snakes in the region
  • Be on the lookout for snakes while trekking, hiking, camping, or while traveling through snake-infested areas (forests, grasslands, thick bushes, even dry woodlands)
  • While walking through such areas, always stay on clear pathways and roads
  • Wear protective clothing such as boots, full length pants, and full-sleeved shirts, while exploring the woods and forestlands
  • Avoiding being outdoors at night in forested areas
  • Do not ignore the warnings on signboards or of forest/wildlife officials
  • Do not probe into dark recesses and crevices with your bare hands; check out for snakes concealed on tree branches or bushes before moving or holding them
  • Wildlife researchers and amateur explorers are requested to carry suitable first aid kits
  • Exercise vigilance while working in farms and fields
  • Keep homes and surrounding areas clean and clear of rubbish or leafy piles, termite mounds, and even building materials
  • Teach and educate children about the dangers and importance of snakes

What are certain Crucial Steps to be followed?

All snake bites should be considered as medical emergencies and accorded prompt attention with evaluation by trained medical professionals, as soon as possible, particularly in the first 4-8 hours.

Do’s:

  • Remove the victim immediately from the spot (prevent further bites)
  • Call your local emergency helpline number (or 911) for help
  • Clean the wound with mild soap and water
  • Immobilize the affected site (arm or leg)
  • Transport the victim without delay to an appropriate health center of care

Don’ts:

  • Do not hesitate to call your emergency help services
  • Do not waste precious time attempting to catch or kill the snake for identification purposes
  • Do not medicate the individual, unless advised by a healthcare professional
  • Do not move the affected region of the body too much
  • Do not run or exercise which might increase the circulation of toxin in the body
  • Do not elevate the affected area above the heart level, since this can also increase circulation of the toxin

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: April 29, 2019
Last updated: April 29, 2019