In an era of health-related misinformation, we take a moment to debunk some common myths.
BTG Specialty Pharmaceuticals 01 October 2020
Snakebites are on the rise this year, with states like Texas seeing a more than 50% increase in snake-related calls to their poison control centers.
This would be worrisome enough on its own. But it also happens to coincide with an era of health-related misinformation, as sham Covid-19 treatments perpetuate and millions, fearing the virus, avoid hospital care. Just recently, a video of a biker bit by a snake – and deciding not to go to the ER – went viral, and if you search “snake bites” on Amazon you’ll find a number of kits with suction cups, tourniquets, and other tools supporting corrosive myths about snakebite treatment.
As snakebite experts, we thought we’d take a moment to debunk some of those common myths – and provide what we hope is a helpful corrective for all those heading outside this summer, and beyond.
Like other myths, using a tourniquet can actually do more harm than good: studies have shown that confining the venom to an extremity where the bite occurred actually causes more damage to that area – without providing any benefit to the victim overall.
What you can do is keep the wound at heart level (e.g. if you were bitten on the arm, drape it over your chest), remove constrictions (e.g. tight clothes, shoes), and stay as still as possible – while, of course, quickly finding your way to a hospital.
We’ve all seen it in the movies – the cowboy gets bit by a snake in the desert somewhere, and his friend prepares to suck (or cut) the venom out. This myth was even perpetuated in old Boy Scout handbooks.
But it doesn’t work. Sucking the venom out can cause the poison to spread to the mouth, and the extractor pumps found in snake kits won’t do any better: a study found that one of the most common extractor pumps extracted bloody fluid but virtually no venom. Meanwhile, cutting it out will only cause more tissue damage and blood loss.
Don’t delay – getting the victim to a hospital as quickly as possible is the best thing you can do.
We ice a lot of things – bruises, sprained bones – but even though snakebites may cause swelling, that doesn’t mean ice will deactivate the venom. Neither will shock treatments or electricity . Obviously, electric shock could also be dangerous the patient.
This myth suggests that specific antivenoms are required to treat bites from different snake types in the US. While that may be true in other parts of the world, 98% of venomous snakebites in the US are from the North American pit viper, including copperheads, cottonmouths, and rattlesnakes. One antivenom, CroFab®, is approved to treat adult and pediatric patients envenomated by any North American pit viper, including rattlesnakes, copperheads and cottonmouths/water moccasins.
Getting a photo of the snake may be helpful if it is safe to do so, but do not try to catch or kill the snake, and do not bring a live or dead snake to the emergency room.
Rather than tracking the snake, track the progress of the venom. Take a new photo of the bite zone every 15 minutes and any red swollen areas until you get to the Emergency Room. This may help the doctor determine the appropriate treatment upon arrival.
While it’s true that most copperhead bites are not fatal, that doesn’t mean they’re harmless. People have died from such bites (and not just those who have an allergic reaction). What’s more, a randomized, double-blind, placebo-controlled study in copperhead envenomation showed prompt treatment results in faster recovery of limb function.
For more information about snake bites, click here. And check out our app, SnakeBite911, which can help locate the nearest hospital that may stock CroFab®, track the progression of the venom, provide detailed information about snakes in your area, and more.
CroFab® Crotalidae Polyvalent Immune Fab (Ovine) is a sheep-derived antivenin indicated for the management of adult and pediatric patients with North American crotalid envenomation. The term crotalid is used to describe the Crotalinae subfamily (formerly known as Crotalidae) of venomous snakes which includes rattlesnakes, copperheads and cottonmouths/water moccasins.
IMPORTANT SAFETY INFORMATION
Do not administer CroFab® to patients with a known history of hypersensitivity to any of its components, or to papaya or papain unless the benefits outweigh the risks and appropriate management for anaphylactic reactions is readily available.
WARNINGS AND PRECAUTIONS
Coagulopathy: In clinical trials, recurrent coagulopathy (the return of a coagulation abnormality after it has been successfully treated with antivenin), characterized by decreased fibrinogen, decreased platelets, and elevated prothrombin time, occurred in approximately half of the patients studied; one patient required re-hospitalization and additional antivenin administration. Recurrent coagulopathy may persist for 1 to 2 weeks or more. Patients who experience coagulopathy due to snakebite should be monitored for recurrent coagulopathy for up to 1 week or longer. During this period, the physician should carefully assess the need for re-treatment with CroFab® and use of any type of anticoagulant or anti-platelet drug.
Hypersensitivity Reactions: Severe hypersensitivity reactions may occur with CroFab®. In case of acute hypersensitivity reactions, including anaphylaxis and anaphylactoid reactions, discontinue infusion and institute appropriate emergency treatment. Patients allergic to papain, chymopapain, other papaya extracts, or the pineapple enzyme bromelain may also have an allergic reaction to CroFab®. Follow-up all patients for signs and symptoms of delayed allergic reactions or serum sickness (e.g., rash, fever, myalgia, arthralgia).
The most common adverse reactions (incidence ≥ 5% of subjects) reported in the clinical studies were urticaria, rash, nausea, pruritus and back pain. Adverse reactions involving the skin and appendages (primarily rash, urticaria, and pruritus) were reported in 12 of the 42 patients. Two patients had a severe allergic reaction (severe hives and a severe rash and pruritus) following treatment and one patient discontinued CroFab® due to an allergic reaction. Recurrent coagulopathy due to envenomation and requiring additional treatment may occur.