# Snake Bite Talk



## Mountain Res-Q (Jul 23, 2009)

Interested in any Snake Bite stories out there.  I know that actual deaths from snake bites (at least in the USA) are rare, but strikes are not.  My county sees quite a few bites every year and snakes have always fascinated me.

What venomous snakes in your area?

Any interesting stories?

What treatments are you doing in your area?

Any other interesting venomous creature stories in your area?

http://www.uniondemocrat.com/200907...reminders-to-use-caution-in-rattler-territory


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## Flight-LP (Jul 23, 2009)

Lots of copperhead and cottonmouth bites around here. Most are treated for pain only with few systemic effects. We will see an occasional coralsnake and rattlesnake bite, and these usually are the only ones that are "treated". Crofab is readily available, but not used as much around Houston as it used to be. Risk vs. benefit I guess.


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## Seaglass (Jul 24, 2009)

Lots of copperheads here, and the occasional cottonmouth or timber rattler. Cases where someone doesn't know what bit them are pretty common, but it's generally assumed it was a copperhead, since they're a lot more common. 

Copperhead bites are just observed, since they dry-bite pretty often. I've even heard that the allergy rate to the antivenin is higher than the actual rate of bites with venom. At any rate, CroFab is available in the area, though it's rarely given.

I've had plenty of experience to support that copperheads aren't aggressive. We had a lot around the house where I grew up, and I tried to keep some as pets when I was very little. Never got bitten... although I'm sure I would've deserved it.

We've also got both brown recluses and black widows. I don't know of any healthy adults who've died from bites, but they're still pretty nasty. Treatment consists of an ice pack and driving to the hospital as far as we're concerned. They tend to show up in urgent care more often, though.

Beyond those, we've also got all kinds of diseases that can be transmitted by the local bugs and animals. Rabies, Lyme, West Nile, you name it... we now supposedly have CWD too, just for extra fun.


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## CAOX3 (Jul 24, 2009)

Whoa I dont like snakes, and why do people keep snakes that can eat their children?


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## mycrofft (Jul 25, 2009)

*Once bitten twice shy*

Late in one afternoon a big, young and not too bright or mature guy comes in with a bandage on his forearm, and says "I think I was bitten by a snake". Ok, we take vitals, remove bandage, and see two puncture marks about 3/4 inch apart on his volar forearm, the area is reddened and swollen and a little dusky near the punctures.

Hmmm.:glare:

When asked if he saw the snake or how this happened he gets sorta vague, then allows as how it was "just under a bush, that's all", and was a "baby rattler".

He is in good shape, having lotsa kilograms per milligrams of venom, but the arm is starting to swell somewhat. Our "doc in a box" had rattler antivenin, the doctor explained patiently that he needed treatment started promptly in the form of invections (antivenin and tetanus)..

"No needles!! No needles!!" the pt shouts, brushes us off and runs out the side doors.

Three days later he's back, feels very unwell, entire forearm swollen, dusky, and there's a deep nasty ulcer around the bite site. The pt says yes to the antivenin, but the doctor explains it is too late just for that, he will need to be transported to the hospital and that we need to start an IV now to help him feel better (and in case he crumped before the squad could come take him away).

"No needles!! No needles!!" and we never saw him again.

(Note: lotsa cranksters around there, and many of them kept and still keep reptiles, including the plentiful local rattlers. A few li bites are recorded every yuear, and guess how those happen).<_<


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## mycrofft (Jul 25, 2009)

*Seaglass, you sound like you're in the Ozarks!*

All you need are centipedes and scorpions and you have most of the common envenomators all wrapped up.


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## usafmedic45 (Jul 25, 2009)

When I was still working in EMS for pay (I was actually just getting off work when the call came in so rode out with the oncoming EMS supervisor then  stuck around the ED after we arrived to see what would happen as this is something I will likely never see again thankfully), we had some numbskull who was bitten by his "pet" Gaboon viper which he was in posession of illegally. The cops never did find out exactly how he got ahold of it; the question I wanted answered more was WHY he wanted to own the snake with the longest fangs on the planet. A cool looking snake, they are not supposed to be (and I quote the guy from the zoo we called to ask about this) "particularly aggressive" but I think that's a relative term for a predator that pretty much operates off instinct and reflex. 

Suffice to say he died a very horrible death with spontaneous hemorrhage into his head, under the skin from even the lightest touch, his abdomen and the compartments of his extremities.   He was seizing and that was preceded by fasciculations along with this generalized edema that slowly spread from the site of the bite on his left forearm to include almost his entire body.  It ranks up there with the most disturbing things I have ever witnessed.  He had the misfortune of getting bitten on the same day as a really major snowstorm going through the area which hampered the ability to transfer him to a more suitable hospital or to bring in antivenom.  Several hours after the bite he died after his brain herniated secondary to massive intracranial hemorrhage.


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## bmennig (Jul 28, 2009)

While I never had to take a snake bite pt, It's always a possibly out here in the backwoods where I'm at. It's a call you tend to forget about until you get it, then it's an "oh sh**" moment.


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## MendoEMT (Jul 28, 2009)

Actually had a discussion the other day about snakes.  For some reason all our ambulances had snake bite kits (venom extractors and other junk) even though those have been out of vogue for some time and our protocols don't let us use them.......


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## Seaglass (Jul 28, 2009)

CAOX3 said:


> Whoa I dont like snakes, and why do people keep snakes that can eat their children?



My parents didn't let me. I knew they wouldn't approve, so I'd smuggle them into the house. 



			
				mycrofft said:
			
		

> All you need are centipedes and scorpions and you have most of the common envenomators all wrapped up.



Not the Ozarks, but yeah, we have lots of poisonous critters in common. We only had snakes until a few years ago, when we started getting poisonous spiders for some reason or another. 

I've lived in places with lots of scorpions before, but never saw a sting. Are there any poisonous centipedes in the US? I don't recall hearing about anyone being bitten before...


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## mycrofft (Jul 28, 2009)

*All centipedes are poisonous, some are too small to count.*

My understanding is the venom acts like the common scorpion venom (referring to domestic varieties of each and excluding the Mojave green scorpion). If the centipede can get it's venom claws through your skin, it can sting. If it tries but fails and you react to the chemicals in it, you might get a little welt.
I saw a guy whose buddy put a little millipede into his sock. When it was partially crushed it released a mild irritant toxin and tiny millipede-shaped welt on the inmate's foot. Dx was by finding the pissed-off dying critter in the sock, about 1 cm long.

The larger millipedes will smell musty and this repellent apparently can be irritating to eyes and tender skin.

Oh, everyone remember "red on yeller, kill a feller; red on black, venom lack"?


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## Sasha (Jul 28, 2009)

> Oh, everyone remember "red on yeller, kill a feller; red on black, venom lack"?



I always heard it "Red on yellow will kill a fellow, red on black is a friend of jack" although I never figured out who jack was


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## HotelCo (Jul 28, 2009)

I remember it as "When red touches yellow, you're a dead fellow. When red touched black, you're OK Jack."


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## Mountain Res-Q (Jul 28, 2009)

HotelCo said:


> I remember it as "When red touches yellow, you're a dead fellow. When red touched black, you're OK Jack."



Has no one ever heard "When you see a snake, pee yourself, and run away screaming like a girl"?

Not that I have ever done that.

My most interesting snake story comes from my Vet Tech years.  In Vet Medicine we see a lot of snake bites, mostly because dogs go where they ought not and stick their noses where they ought not.  About 6-7 years ago we saw a Doxie with every s/s of an envenomation, but no localized swealling that we could see and no puncture site that we could see.  So we treated like an allergic reaction and observed... after several hours of the dog not improving and seeming to get worse, someone had the idea to check the mouth; the only area on the dog that we could not (he was not having it and was very agressive).  Welll of course he was... it was painful.  After some general anesthesia we opened the mouth and found that the tounge was three-four times it's normal size with two puncture marks right in front.  Now, don't ask me what set of circumstances could lead to any creature getting a snike bite to the tounge... 

Oh, and in case you are wondering... treated with steroids, antihystamines, abs, and fluid therapy...  dog died that night.  Anti-venom (at least at the versions we had back then) were a long shot at having any useful effects (and were expensive - $600+).


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## Sasha (Jul 28, 2009)

Mountain Res-Q said:


> Has no one ever heard "When you see a snake, pee yourself, and run away screaming like a girl"?
> 
> Not that I have ever done that.
> 
> ...



Poor puppy :[


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## Seaglass (Jul 30, 2009)

mycrofft said:


> My understanding is the venom acts like the common scorpion venom (referring to domestic varieties of each and excluding the Mojave green scorpion). If the centipede can get it's venom claws through your skin, it can sting. If it tries but fails and you react to the chemicals in it, you might get a little welt.
> I saw a guy whose buddy put a little millipede into his sock. When it was partially crushed it released a mild irritant toxin and tiny millipede-shaped welt on the inmate's foot. Dx was by finding the pissed-off dying critter in the sock, about 1 cm long.
> 
> The larger millipedes will smell musty and this repellent apparently can be irritating to eyes and tender skin.
> ...



Thanks. Never knew that. We have some around here, but they're mostly pretty small. 

I forgot another venomous critter--killer bees. The media made a big deal about one or two being sighted in my area a few years ago, and nothing ever came of it. 

And I always heard it as "red on yellow, kill a fellow." Never knew it had a second part.


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## Fireguy (Jul 30, 2009)

I never had a snake bite PT(knock on wood). One night at the fire station we received a phone call for a snake in someones basement.  We told them to call the state police because they would gladly handle that.  The homeowner replied with a snicker, "already did and they told me to call you".


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## Epi-do (Jul 30, 2009)

Supposedly, we have rattlers around here.  You go to the southern part of the state and there are supposed to be cottonmouths and copperheads.  I don't think they are that common though, and of the three I have only ever seen one.  It was a copperhead curled up next to a rock along a trail at a state park.  We gave it a wide enough berth it never even gave us a second glance.

We do have brown recluse spiders around here, and infact, I have seen several bites from them.  Fortunately, none of them were severe bites.


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## fma08 (Jul 30, 2009)

Sasha said:


> I always heard it "Red on yellow will kill a fellow, red on black is a friend of jack" although I never figured out who jack was



Jack was the guy who lived to make up the rhyme


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## FFMckenzie (Jul 31, 2009)

mycrofft said:


> My understanding is the venom acts like the common scorpion venom (referring to domestic varieties of each and excluding the Mojave green scorpion). If the centipede can get it's venom claws through your skin, it can sting. If it tries but fails and you react to the chemicals in it, you might get a little welt.
> I saw a guy whose buddy put a little millipede into his sock. When it was partially crushed it released a mild irritant toxin and tiny millipede-shaped welt on the inmate's foot. Dx was by finding the pissed-off dying critter in the sock, about 1 cm long.
> 
> The larger millipedes will smell musty and this repellent apparently can be irritating to eyes and tender skin.
> ...




Are you a crew captain? why are you watching inmates putting bugs in each others shoes hmmm. 

Also for coastal people dont forget jellyfish. They mostly have mild stings but they can also cause anaphylaxis.


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## mycrofft (Jul 31, 2009)

*Not a crew captain, it was an "emergency" call. I do those.*

They were playing handball and he had taken off his shoes.

HAHA!! I forgot jellyfish. Got a bit from a little torn up one off El Segundo, CA, body surfing. Usually we would just quickly scrub off these bits with sand (when the surf tore them up) but this one went were I couldn't scrub in public. End of body surfing that day.


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## Jon (Aug 1, 2009)

Snake bite treatment? Don't cut the bite site. Don't use suction. Don't use a tourniquet.

The Boy Scout First Aid guides recommend a "constricting bandage, but NOT a tourniquet"


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## mycrofft (Aug 1, 2009)

*How many species of rattlers are there in the USA?*

And are there species in the US which have NO listed fatalities?


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## Sasha (Aug 1, 2009)

mycrofft said:


> They were playing handball and he had taken off his shoes.
> 
> HAHA!! I forgot jellyfish. Got a bit from a little torn up one off El Segundo, CA, body surfing. Usually we would just quickly scrub off these bits with sand (when the surf tore them up) but this one went were I couldn't scrub in public. End of body surfing that day.



I stepped on a jellyfish on shore a couple years ago. BLended in with the sand but their stingers still stung after death. Stuck to the pool the rest of the visit.

Anyone have man'o'wars?


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## mycrofft (Aug 2, 2009)

*I saw one once.*

A real fluke, off California (!). Initially I took it for a produce bag at fifty yards and from a pier.


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## mycrofft (Jul 5, 2011)

*Time for a refresher, rattler bumper crop this year*

Three clues:
1. Cat brings in multiple rodents a week for owner to prep and serve to it.
2. Many rodents and rodent predators seen as roadkill (constrictor snakes, barn owls, cats, maybe coyotes) or perched on lookouts like light stancions and dead trees. Barn owls are notorious for going after roadkill rodents at night, their remains are buffy and white with some spotted brown on white feathers. You might see them alive on the road or on the shoulder, too, after dark.
3. You see the rattlers (duh-OH).

SO, what is the latest and greatest? I have been doing some reading, and I am not seeing U.S. resources willing to make different recommendations for wilderness or rural bites versus urban or suburban bites. Constrictions are out. Cold is out. Basically, call 911, keep calm (yeah right), scene safety, and get your medical history and insurance info handy in case you pass out first. We locally only have numerous but geographically concentrated Northern Pacific Rattlers.

Can our comrades down under give us their expertise too, since we Amurricans seem to a relatively limited number of families of well-known poisonous snakes*, (albeit there are or were about 13 varieties of rattlers at one time).


* We have rear fanged snakes like gopher snakes, lyre snakes, cat eye snakes, etc., who are mostly very secretive and rural and have few or no recorded fatalities.


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## vamike (Jul 5, 2011)

Here in these hills we have rattlers and copperheads.  I grew up in eastern part of the state and we had cotton mouths and copperheads.  All over the state we have black widows and brown recluses. My father was bit by a recluse a few years back with no serious reaction.  My nephew was bitten a couple years before that on his finger and it required several surgeries of splitting the skin on his finger and scraping the insides clean.  Lots of antibiotics later and he still has the finger.  Nasty things those brown recluses.


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## usafmedic45 (Jul 5, 2011)

> We have rear fanged snakes like gopher snakes, lyre snakes, cat eye snakes, etc., who are mostly very secretive and rural and have few or no recorded fatalities.



That would be because they are not venomous.  It's hard to have a fatality unless you're dealing with a very venomous snake (even rattlesnake bites are seldom fatal; they make the patient wish they were dead, but it seldom is irreversibly fatal) or one big enough to asphyxiate a person.  Also keep in mind that even with venomous species, approximately 50% of all bites are dry bites.


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## CANMAN (Jul 5, 2011)

Had a lady in Baltimore in the last two years that got bit by a Cobra. She told police she saw a white plastic shopping bag moving under her car in a Supermarket parking lot and when she went to pick it up a cobra was in the bag and bit her :rofl: Turns out her and her husband collected exotic snakes without the proper permits and she got bit by one of her own snakes. She was transfered to the hospital I worked at from a community hospital. 

Tracking down anti-venom was the issue. The Baltimore Zoo had anti-venom but it was expired. After alot of phonecalls some was located in PA somewhere. Due to weather we were unable to fly to retrieve it so a PA State Trooper brought it to a DE State Trooper and we met them at the State line in one of the special ops cars to bring it back. 

She had a decent outcome as far as I know. Got bit in the hand and did have some tissue necrosis. They had the snake in the ED which was pretty cool to see. It was relatively small/younger snake, black and yellow. Used to have a cool pic of it on my old phone.


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## CANMAN (Jul 5, 2011)

I think Miami also had a fire department based unit called "Venom 1" who's sole duty is to respond to areas all over the state and provide anti-venom. Apparently the FL ports have the highest imports of exotic animals.


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## zmedic (Jul 5, 2011)

mycrofft; said:
			
		

> Can our comrades down under give us their expertise too, since we Amurricans seem to a relatively limited number of families of well-known poisonous snakes*, (albeit there are or were about 13 varieties of rattlers at one time).



Keep in mind that many of the venomous snakes in Australia are neurotoxic snakes, so they use constrictor bands. In the US almost all snake bites from local snakes are from hemotoxic snakes, so no ace wraps used. (The only native neurotoxic snake to north america is the coral snake, which you have to basically pick up and poke to get bitten, usually on the hand or finger.)


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## Aussie_Medic_Girl (Jul 5, 2011)

mycrofft said:


> Can our comrades down under give us their expertise too, since we Amurricans seem to a relatively limited number of families of well-known poisonous snakes*, (albeit there are or were about 13 varieties of rattlers at one time).
> 
> 
> * We have rear fanged snakes like gopher snakes, lyre snakes, cat eye snakes, etc., who are mostly very secretive and rural and have few or no recorded fatalities.



I don't know about my expertise but I can give you a bit of a view of snakes in Oz. Here the standard treatment is to cover the bite with a sterile pad, compression bandage from the bite upwards towards the body and then once that bandage is exhausted you start another one at the most distal end of the limb and move all the way to the top of the limb using as many bandages as required. We then mark the bandage for where the bite mark is and the time it was applied. The limb is then immobilised with a splint and the pt tx to hospital. I understand that in America you don't compression bandage as that causes further necrosis??? 

Now I personally haven't actually attended someone who has been bitten by a snake. I've been to one person who stood on a snake but wasn't sure if it bit her as she couldn't see underneath her foot and I also went to a kid who was playing in the floodwaters and was bitten by "something" (inspection showed a very minute midgie bite). However, I was unloading at hospital one day when a 4wd pulled up and a women jumped out carrying a 3yo and screaming that he'd been bitten by a brown snake. We rushed them inside and when I went outside to let grandma in she was kindly waving a ~30cm brown snake around. Now while I don't know all the details of the case I do know that the kid had problems with his clotting that were bad enough the hospital gave anti-venom. Just goes to show how a small snake can still be just as dangerous. 

So...other than that, I've just driven over a 6ft brown snake in the ambulance


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## mycrofft (Jul 5, 2011)

*Rear fanged American snakes, and neurotoxic North American rattler*

Rear-fanged snakes have venom "considered not dangerous to humans" (unless you are allergic). You practically have to pry open their mouths and jam in a finger to be envenomated. That's after you go hunt one down, except for some more familiar _coluber_ sp., the hognosed snake being a somewhat common pet snake. Here's a remarkable h34r: pictoral of a hognosed snake bite tolerated for 3 to 5 minutes.
http://www.herpnet.net/bite/

We have a neurotoxic rattler (pit viper, crotalidae) known as the Mojave (sic "Mohave") Rattlesnake, aka "Mohave Green Rattler".
http://emedicine.medscape.com/article/771586-overview#a0104

American Association of Family Physicians' 2002 article states:

"Each year, approximately 8,000 venomous snakebites occur in the United States.1,2 Between 1960 and 1990, no more than 12 fatalities from snake venom poisoning were reported annually". http://www.aafp.org/afp/2002/0401/p1367.html


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## Hockey (Jul 6, 2011)

Any snake is a dead snake to me


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## jsliu (Jul 14, 2011)

I live in Moreno Valley, CA in Riverside County and just on the other side of my backyard fence are some mountains so I've seen a lot of rattlesnakes and king snakes growing up. King snakes aren't poisonous, in fact, they eat rattlesnakes, so I welcome them, but rattlers are a different story.

No one in my family has been bitten but four years ago, my dog was bitten by a rattlesnake on his snout and I had to rush him to the animal ER. Luckily, he survived but his face got really bloated from the venom so he had surgery to get all the venom out. He still chases after them but he's smarter about getting bit again and each year, I also take him to the vet for the rattlesnake booster.


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## LucidResq (Jul 14, 2011)

A canyon/public park (at relatively low elevation for CO) in the jurisdiction my boyfriend volunteers for has had an odd rash of rattler bites this year. At least two dogs have died and I believe they've transported 4-5 patients- those are just the ones him and I have heard of. I don't believe any of them were in bad shape but I don't know what their clinical course was after transport. I'm almost positive all of them survived without serious consequences though (aside from their hospital bill).


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## medichopeful (Jul 15, 2011)

This reminds me.  Did you ever catch the show "Venom ER" when it was on?


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## emtchick171 (Jul 15, 2011)

Have seen some man-o-wars on the coast, not a frequent occurrence but they're definitely there! Jellyfish are common, the best thing we have found for a jellyfish sting is ammonia, or vinegar...although it smells bad, it will neutralize the jelly sting and make it stop hurting. 

Snakes in our area: timber rattler, cottonmouth/water moccasin...for the most poisonous. Then there's the common chicken snakes, and garden snakes that you see often but are harmless.


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## mycrofft (Jul 15, 2011)

*"Venom ER" was in my old childhood stomping grounds, high Mojave/San Berdoo County*

Long darned chopper rides.

We are seeing rattlers in suburban Sacramento where few or none have been seen recent years. It has been a bumper crop year for rodents two years running, and that's what the rattlers eat; the wild grass/brush is high, that';s where they hunt; the river's are running high, displacing them from their riparian environment.


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## lifesavingsob (Jul 25, 2011)

Mountain Res-Q said:


> Interested in any Snake Bite stories out there.  I know that actual deaths from snake bites (at least in the USA) are rare, but strikes are not.  My county sees quite a few bites every year and snakes have always fascinated me.
> 
> What venomous snakes in your area?
> 
> ...



I ate a rattlesnake one time... we was drunk too, rolled up on him on our four-wheeler, I was all "run over that :censored: and see what happens"... he was all wiggling and he tried to bite me I said "no snake!" Then I beat him in the head with my machete... said "I'm about to eat you with some mayonaise you snake"...


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## McGoo (Aug 8, 2011)

We don't have many snakes in the city, but you don't have to go far to find some rather nasty ones. Off the top of my head I think we have four or five of the top ten deadliest in my state, and two or three of them within an hours drive. Mainly we have to watch out for the duguite and death adder, with the taipan living further north. As bad as they are though, bites are rare as the population is quite sparse, and most people take reasonable precautions when in the bush.


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## wildrivermedic (Aug 10, 2011)

mycrofft said:


> [FONT="Courier New" * We have rear fanged snakes like gopher snakes, lyre snakes, cat eye snakes, etc., who are mostly very secretive and rural and have few or no recorded fatalities.[/FONT][/QUOTE]
> 
> I am also quite secretive and rural, so I got to record a King snake fatal attack... on a rooster.
> 
> ...


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## mycrofft (Aug 10, 2011)

*Echinnacea topical application*

The NIH paper was about damaging a pig's vocal cord then applying the concotion to it to see if a subject's voice could be better restored versus recovery without. Snakebites and other envenomations are not superficial, and the insults they tested were not toxic. There is no scientific evidence as of now that any topical poultice will actually ameliorate a spider or snake or other subdermal envenomation.

Other poultices have included mashed boiled or refried beans (highly hygrophyllic), parts of the offending animal, onion and salt, and various combinations of medicinal plants. None prove truly effective against envenomated bites (and many bites are NOT envenomed); if you are interested in more about this sort of lore, read the FOXFIRE books, see this link:
http://www.herbvideos.com/bites.htm

I could have asked my grand-auntie in the Ozarks, but she died living (unbitten) amongst her yard -full of copperheds.


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