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Summer 2014 - Talk with the Venom Doc

Summertime means more of our slithery friends are coming out to play, so we caught up with Dr. Benjamin German, emergency medicine physician (also known as the Venom Doc). He’s a snake enthusiast who believes that families need to be educated about the facts so they can reduce their fears and take safety precautions while enjoying the beautiful outdoors in North Carolina.

When did you take an interest in snakes?
I’ve liked snakes since I was a small child. So I know that curious kids need to understand to take caution and be educated about the fact that some are dangerous.

Which dangerous snakes are most common in our area?
In North Carolina, we have four types of venomous snakes.

  • Copperhead snakes are the most common venomous snakes in Wake County and surrounding areas. You can find them anywhere in NC from the mountains to the coast. Bites are painful and cause swelling but are usually not as severe as rattlesnake or cottonmouth bites.
  • Rattlesnake bites are a lot more serious than copperhead bites. These snakes are more common in the mountains or the eastern part of NC. You will most likely find them in undisturbed areas (big tracks of forest, game lands, etc.).
  • Cottonmouth is a common name for the water moccasin. The name comes from the white lining in the snake’s mouth that they show when trying to scare predators away. There are many harmless water snakes that swim under water, but the water moccasin tends to stay close to the surface of the water. They are more common east and south of the Triangle.
  • Coral snakes are red, black and yellow, and they are primarily found near the coast in the Wilmington area. These are very dangerous snakes, but there has never actually been a reported coral snake bite in NC.
Quick Tips for a Snake Bite
  • Act quickly: Call 911 if venomous or the type is unknown. A mobile phone is your best tool in the first aid kit.
  • If in the wilderness, get to help as fast as possible. Find a forest ranger.
  • If you can’t reach anyone by phone, send someone for help.
  • As a last resort, carefully carry the person to someone with a phone.

How many snakebites are reported in the area?
We treat approximately 100 snakebites a year in WakeMed emergency departments. Of these, 60 percent show signs of envenomation. The other 40 percent are either dry bites (no venom injected) or they are from harmless snakes. We have already seen more than 30 bite incidents this year as of late May.

What are the biggest concerns with a snakebite?
In rare cases, a person could lose part of a limb or worse. Having a good outcome is all about timing and taking the right steps.

Are the concerns different for children?
Bites can be more severe for kids because kids are smaller, and it’s the same amount of venom. Some kids will pick snakes up out of curiosity, and that’s a common scenario for a bite.

What should you do if a snake bites someone?
Always call 911 if you think a venomous bite may have occurred. If there is any uncertainty, don’t delay. While waiting, clean the area with basic soap and water. Avoid doing any of the old suction, cutting or tourniquet tricks that you may have learned in the past. Keep the bite victim calm and still (minimize movement of their extremities). Reassure them that it’s treatable and almost never fatal.

Summer 2014 NC Snakes

* In the U.S., fewer than five people die each year from snakebites. Typically they are cases where people didn’t seek quick treatment or had very unusual circumstances.

When and where do snakebites happen the most?
Most snakebites happen close to home in yards, parks and along trails. It’s common for people to let their guard down in more familiar areas. The warmer months are when both people and snakes start to move around more. Snakes like wooded areas, overgrown lots and creek banks (not necessarily in the water). You will also find them around bushes, fallen logs, leaf litter, mulch piles and rock walls with crevices.

Are there common bite situations that people should know about?
Frequently, bites happen when people don’t watch where they are putting their hands or feet. Snakes tend to be nocturnal so many bites happen at dusk when people are taking out the trash in bare feet or cleaning up landscaping debris late in the day. If you reach into an area and startle them or step on them, snakes bite in self-defense. Good footwear goes a long way in preventing bites.

What should families know to minimize a bite risk?

  • Look where you are walking and reaching.
  • Teach children not to pick up or poke snakes (not even with a stick).
  • Instruct kids to walk away and tell an adult if they see a snake.
  • Don’t teach kids to kill a snake. They are more likely to get a bite.
  • Snakes can actually still bite you after you think they are dead.*

* Even when a snake’s head is severed from its body, it can still bite for an hour after or more. If a snake poses a danger and is killed, it should be buried out of reach.

How can families keep snakes away from their homes?
The best thing to do is make your yard unattractive to them. They don’t want to be out in the open. Don’t give them a home or place to hide. Keep things trimmed up and off the ground. Bird feeders can attract them because the food underneath attracts mice and squirrels, which snakes prey on. So keep feeders further away from the house or out in the open where you can see what’s going on.

Are there any myths you want to debunk?
Snakes aren’t likely to go out of their way to bite you, and they don’t chase you. Even the ones that can move quickly aren’t going to outpace a person who purposefully walks away. They typically don’t transmit diseases. Don’t put a lot of faith in snake repellents; they aren’t really necessary.

What do you tell people who are afraid of snakes?
Keep your cool. People can get over their fears and learn not to overreact by learning a little bit about snakes. Take the family to a museum and watch snakes in enclosed cases. You’ll see they aren’t that active. They tend to just sit in the same spot and wait for prey. Remember, people aren’t really their prey.

Why do snakes bite?
If they bite someone, it’s a last resort for them. They don’t gain from it. Occasionally, if you step in front of one, they might mistake you for a food source. Otherwise, they bite when they are startled, antagonized or scared.

What’s the typical treatment for a bite?
Anytime there is a bite, you should get checked by a doctor. If the snake is venomous or you are unsure, call 911. The emergency treatment is usually anti-venom, but it’s not always necessary. A doctor will check your blood, monitor swelling, treat pain and determine if antivenom is needed. If you only have minor symptoms, you may simply be monitored and then discharged.

If the bite is not from a venomous snake, there isn’t much to do. Your doctor may recommend a tetanus shot, and that’s about it.




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