Re: At half dome a rattlesnake

First time last week!! Just curious I saw no warnings for rattlesnakes but saw one at the pit stop near the waterfall. That would be really bad to be bit 2-3 hours away from medical help. Are rattlesnakes common up there or are they rarely seen?

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Just do it

I almost stepped on one on the Snow Creek trail. Missed it by about an inch. But that's the only one I've ever seen in the Yosemite Valley area.

The Pate Valley is another story. They were everywhere

rms808 wrote:
> First time last week!! Just curious I saw no warnings for
> rattlesnakes but saw one at the pit stop near the waterfall.

Sort of funny they'd be at the "pit" stop being as how they're pit vipers...8^)

I've never seen one in the area, though I guess this means I'll leave the suction kit in my backpack. I live in an area where there are a significant number of rattlers, but have not been so careful of watching for them in Yosemite. Maybe it has to do with yearly climate...this being an extremely dry year may have brought them to an area they usually aren't.

It's like pulling teeth to find out what to do for a bite. Everything says "get to a hospital and get antivenin", which is fine, but they seem to ignore the fact that there may be situations where that's impossible. And what if it will take 8 hours? Do you sit there with the stuff circulating and just wait around for "professional help"?

I carry a little kit with a suction syringe (not the old-fashioned snakebite kit) that I think would be pretty effective in extracting the venom if it's done quickly. But it just seemed odd to me that in researching what to do, they do say not to do the old tourniquet, crosscuts and suction thing, but they don't tell you what TO do (other than get to a hospital).

Sort of like if you wanted to know what to do if you were starving in the wilderness, and they said "get to a phone and order a pizza". 8^)

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Gary
Yosemite Photo Galleries: http://www.pbase.com/roberthouse/yo

I saw a baby rattler on the Chilnualna Falls trail last year.

I also saw three rubber boas on the Panorama trail, though those are not dangerous. You can't even get them to bite if you try.

Not surprisingly they are common along streams below The Rockslides. Seen two good sized ones in the last few years.

...David

http://www.davidsenesac.com

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http://www.davidsenesac.com

Only rattlesnake I've ever seen in the Sierra was about 2 miles below Mist Fall and just north of the bridge across Kings River where the river meets Bubbs Creek in Kings Canyon NP. So you are lucky to see one. Quite a rare sighting, slightly less rare than a Mountain Lion (which I'm still seeking).

If you get bit in the back country say three days or so from the help that your hiking buddy went for your only choice is to lay there and survive or die. More than likely you will survive as a bite will usually only be fatal to a person that is very allergic to the venom.

The snakes around the Yosemite area are very mellow and won't bite unless you actually step on them. I've put my foot down within inches of them several times while hiking in the past years and only got a rattle as they moved off. One on the trail to Ranchera Creek out of Hetch Hetchy had no buttons just a blunt end.

Ninety percent of the venomous snake bites in the US are on the hands and face indicating perhaps some handling of the snakes. The other 10% are on the foot or lower leg.

I haven't seen a rattler in the past three years.

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Old Dude

I haven't seen many rattlers in Yosemite valley myself. Hetch Hetchy, now that's a different story. I hiked for about a week there about 15 years ago, and there were rattlers literally everywhere. Must've seen 25-30 sunning themselves next to and on the trail.

Needless to say, we were very careful with every step we took.

Last year at Mirror Lake we heard a squirrel making a ton of noise. I went to see what it was freaking out about only to see a HUGE rattlesnake approaching the trail. That snake must have been 4-5 feet long!!!

So I guess you should be careful where ever you are in the park.



Post Edited (07-05-07 16:57)

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Dan

Dan-O wrote:

> Last year at Mirror Lake we heard a squirrel making a ton of
> noise. I went to see what it was freaking out about only to see
> a HUGE rattlesnake approaching the trail. That snake must have
> been 4-5 feet long!!!

It was above Mirror Lake on the Snow Creek trail where I saw my first Yosemite rattlesnake. After stepping about an inch from his head and teleporting myself 15 down the trail at the sound of his rattle I sat and watched him for a while. A squirrel came up face to face with the snake and started screaming at him. I thought the squirrel was a goner for sure, but the snake eventually just slithered away.

I saw a small rattle snake in an area below the Royal Arches that we always called "the indian caves". I was climbing up into a rock crevice and right when I popped my head over a rock I saw the snake about 2 feet away. It scared the **** out of me and I almost fell trying to duck away.

A good reason to use trekking poles? I try to convince myself the poles help scare them away before my foot gets to them.

A Light Snake Story

My brother-in-law was going cross country from Kibbie Lake to Many Islands Lake a few years back when rattlers were seen quit a bit. On the way there is a rock fall that requires some crawling through and under some of the big chunks. He was well into the crawl when he heard the "Bzzzzzz" just overhead and slightly behind him. He quickly finished the trip through the tunnel with the "Bzzzzzz" following him. Turns out that his electric toothbrush got turned on when his backpack rubbed against the rocks.

I've also seen him levitate about two feet vertical and three feet sideways on the trail toward Tiltill Mountain above Rancheria Falls.

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Old Dude

I don't know about Yosemite rattlesnakes being "mellow" - this seems naive to me. My boyfriend was bitten by a rattlesnake and he nearly died. This was hiking in the LA area in early Feb. last year. The snake bit him twice on the shin and pumped a LOT of venom in. He was airlifted and to the hospital within an hour, got lots of antivenin over the course of several days, but it took over a month to recover, and even in the hospital things were pretty shaky at times (thought he might die).

Right when it happened, I tried sucking out the venom - yes, they say not to do that too. Also poured water on it. Not sure if it did anything or not. Almost immediately, he said his face started tingling and he felt faint. Then while I went for help (no cell coverage where we were), he tried walking for a ways to get in a better spot, then he sat down and put a tourniquet on his leg. As soon as they got there, the EMT guys in the copter took off the tournique - but I think that was a mistake, as his symptoms worsened really, really fast after that. Symptoms prior to that were mild in comparison. The EMT guys really didn't know what to do - the emergency 911 operator totally didn't know what to do either (I kept asking what to do and he didn't know what to tell me).

You can't find definitive info on what to do because bites are so rare, and they can't do clinical trials on how to deal with the poison, so they're just guessing.

My non-professional/non-medical advice based upon this experience would be to put a LIGHT tourniquet on to restrict flow but not cut it off - they advise against applying a tourniquet because it can do way more damage if you cut off circulation to the limb, they might have to amputate because of a bad tourniquet even if the bite wasn't that bad. Keep the bite location below the heart (e.g., sit up and keep your leg down - don't lay down, don't elevate the leg). You want to prevent the poison from moving through your system. The venom works in a similar way as the digestive juices in your stomach - it breaks down tissue. Totally not fun. Better to keep it localized. It does nasty stuff to the brain, too - hallucinations, etc.

It's possible to get a "dry bite" with no venom - I think you'd know pretty fast based upon how the victim felt whether there was poison in it or not. Should still seek treatment no matter what.

I don't know if those snakebite kits work but I'd include one in my pack if I was going somewhere where lots of snakes were being seen.

The antivenin is very expensive, something like $5000 per dose (he needed a bunch of doses over about a week, $60k total cost). It's not stocked at all hospitals. Getting to the hospital is the most important thing - time to treatment really matters here. It also takes a little while to prepare the dose - have to mix this powder very gently. The nurses took about 20 minutes to get it ready once the pharmacy finally delivered it to the ER. He got progressively worse during that time, symptoms came on very quickly after the tourniquet was off, and kept getting worse. Massive swelling and redness from the bite moving up the leg, really low blood pressure, delirious, etc.

Again, time really matters here: I had to leave my boyfriend alone on the trail to go get help, which was awful but I'd do it again.

Always wear long pants when hiking! Watch where you step. I was on the trail ahead of him and we think maybe I startled the snake, then when my boyfriend came through, he was the one who got bit. We didn't hear any warning. It was awful.

mytwocents wrote:

> I don't know about Yosemite rattlesnakes being "mellow" - this
> seems naive to me. My boyfriend was bitten by a rattlesnake and
> he nearly died. This was hiking in the LA area in early Feb.
> last year. The snake bit him twice on the shin and pumped a LOT
> of venom in. He was airlifted and to the hospital within an
> hour, got lots of antivenin over the course of several days,
> but it took over a month to recover, and even in the hospital
> things were pretty shaky at times (thought he might die).

I don't know about "mellow", but for the most part rattlesnakes are hardly biologically equipped to kill humans. They're after mice and other rodents.

> Always wear long pants when hiking! Watch where you step. I was
> on the trail ahead of him and we think maybe I startled the
> snake, then when my boyfriend came through, he was the one who
> got bit. We didn't hear any warning. It was awful.

How do long pants help with snake bites?

A lot of misinformation on this thread. Let's try some better info. I am a physician in SoCal.

Currently, the best medical information is that the only thing which alters the course post-bite, is to get anti-venom. The ONLY thing. I guess one of the best ways to educate is through repetition.

"It's like pulling teeth to find out what to do for a bite. Everything says "get to a hospital and get antivenin", which is fine, but they seem to ignore the fact that there may be situations where that's impossible. And what if it will take 8 hours?"

You get to a hospital and get antivenom.

"Do you sit there with the stuff circulating and just wait around for "professional help"?"

No, you get to a hospital and get antivenom

"I carry a little kit with a suction syringe (not the old-fashioned snakebite kit) that I think would be pretty effective in extracting the venom if it's done quickly."
Of the many kits out there, only the one made with a Sawyer Extractor was thought to be of any help. That is no longer really thought so, either. So using this creates a delay....in getting to a hospital and getting antivenom.

"But it just seemed odd to me that in researching what to do, they do say not to do the old tourniquet,"
Doesn't work, increases bad outcomes.
" crosscuts and suction thing,"
Doesn't work, increases bad outcomes.
"but they don't tell you what TO do (other than get to a hospital)."

Because NOTHING else does any good, except to get to a hospital and get antivenom. Some of the things cause significant damage, some HUGELY increase the risk of loss of limb. Best to sit down, have someone go for help. If you are by yourself, you will have to try to get out, or sit it out. If you are a long ways into the backcountry, you will have to sit it out.

"Right when it happened, I tried sucking out the venom - yes, they say not to do that too."
One of the biggest complications is infection of these wounds, where the snakebite has tremendously compromised the local immune system. You applied one of the filthiest sources of infective bacteria to this wound, tremendously increasing the chances of such an infection. Bad idea.

"As soon as they got there, the EMT guys in the copter took off the tournique - but I think that was a mistake, as his symptoms worsened really, really fast after that."

No, they probably saved his leg. The tourniquet was localizing the venom into his leg, where it could actively concentrate and attack the tissues. When released, it circulated throughout his body, increasing his symptoms, but decreasing the assault upon his leg. The symptoms caused by the venom in the body is reversed by the antivenom, and can be treated with medical approaches. The damaged caused by the localized venom trapped in the leg CANNOT be treated, other than by surgery or amputation.

"The EMT guys really didn't know what to do"

They did exactly the right thing...get the tourniquet off, treat for shock, transport.

"You can't find definitive info on what to do because bites are so rare, and they can't do clinical trials on how to deal with the poison, so they're just guessing."

There is lOTS of definitive info on what to do. Bites are NOT rare. There are many clinical trails. The guessing ended 30 years ago. Look at the brief references at the bottom. You can find hundreds, if you look.

" My non-professional/non-medical advice based upon this experience would be"

Stop right there. Understand that I think you mean well. You have a grand total of experience of one bite, in a situation where you could not be objective. The advice you give is not only wrong and contradicts all experts, all studies, and all experience, but if followed has the potential to cause serious harm.
DON'T place a touniquet.
You DO want to have the venom circulate through your system, where it is better able to deal with it and dilute it.
It is NOT better to keep it localized.

"I don't know if those snakebite kits work but I'd include one in my pack if"

They don't work, delay the time to treatment that actually is helpful (hospitalization and antivenom). Save the weight.


Some references. Note that older references may give old techniques

http://www.emedicine.com/emerg/topic540.htm
http://www.krpc.com/proffed/snake%5CSnakebite.cfm
http://www.sloanmonster.com/index.php?page=Twosnakebit&message=Two%20locals%20get%20snake%20bit
http://pediatrics.aappublications.org/cgi/content/full/110/5/968



Post Edited (07-09-07 15:34)

Doctor,
Thank you for your informative post. I and my backpacking buddies have been trying to get an opinion on what do in the event of a bite two or three days from help as we are often in that position. It seems, in a nutshell, the best thing to do when days from help is to just sit and wait it out without trying to administer any kind of first aid.

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Old Dude

mrcondron wrote:

> Doctor,
> Thank you for your informative post. I and my backpacking
> buddies have been trying to get an opinion on what do in the
> event of a bite two or three days from help as we are often in
> that position. It seems, in a nutshell, the best thing to do
> when days from help is to just sit and wait it out without
> trying to administer any kind of first aid.

Really? What I got from his post was that the best thing isn't to wait it out, but to get the bite victim ASAP to a place where antivenom can be administered.

I reread my post and it isn't as clear as I thought. I was referring to the situation where it is at least two to three days before one of the hikers can get help and maybe another one to two days before help arrives. (excludes helicopter)

The victim should sit it out until help arrives. It could be five days after the bite and by then the emergency could have passed one way or another.

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Old Dude

I appreciate the information; it clarifies things somewhat, and really stresses that if possible, you should get to medical help as quickly as possible.

The extractor I was referring is the Sawyer model mentioned, and I'm afraid that despite the advice, if I was a significant distance from help or communication, I'd use it. The amount of time lost is but a few minutes, and if you're a half day or couple of days away from any help, I can't see the few minutes being much of an issue, and it may help...in fact, I can't see how having less venom circulating can be anything but beneficial.

When I first got the extractor, my adult daughter was visiting and got her foot stung by a wasp. I happened to be right there and the Sawyer kit was in the car, so I figured that would be a good chance to familiarize myself with it. You could have knocked me over when, even though it had been a few minutes, I saw the venom form a droplet inside the extractor's clear cup. She had virtually no reaction to that sting, and she is normally reactive to bee and wasp stings.

So common sense tells me that if a snake injects venom, and I can suck at least part of it out, that's a good thing in general. It would be interesting to know how it was concluded that it wasn't (disregarding the "delay" part). When you're an hour or two from help, the delay may be a factor, but I'd have to see some pretty convincing evidence with people who were say, several hours from help, with one treated with the Sawyer and one not, that it's not worth doing. Of course, even at that, it would take testing of a good number of people to form any valid conclusion, as people and bites are different.

Scenario: Hiking alone, six hours out from civilization, you get bit. You don't know anything about cell phone usability on your route back, there are no land phones, and you don't know how well you're going to be able to walk, or how quickly, after the venom takes effect. Do you say "I'll gamble that I'll soon get cell phone communication so to heck with the suction, I'm walking." Or do you, for "insurance", whip out the Sawyer, spend a few minutes sucking out all you can get, and then heading back? I can tell you pretty confidently which of those two choices I'd take, regardless of the few minutes (maybe) wasted. If halfway back, I'm dragging and still no communication, and I hadn't given it a try, I'd have a hard time feeling like I did the right thing.

So I'm not disputing the "get medical help asap" part, but I also like to have an idea, in advance, what to do if that's not feasible or you don't know if it's going to be possible.



Post Edited (07-10-07 12:40)

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Gary
Yosemite Photo Galleries: http://www.pbase.com/roberthouse/yo

Gary, I understand that we all wish that things worked the way that we wanted them to, or that we would like them to, but sometimes, they simply don't.

Here is a link to how NOLS has changed it's program with respect to extractors, because they have been demonstrated to NOT WORK. We all wished they worked, we all want them to work......but they don't. However, if you follow the directions, and leave it in place for 30-60 minutes, you have lost 1/2 half of the time before systemic symptoms are likely to start, making walking more difficult or impossible. Do you really want to do that?

"Scenario: Hiking alone, six hours out from civilization, you get bit. You don't know anything about cell phone usability on your route back, there are no land phones, and you don't know how well you're going to be able to walk, or how quickly, after the venom takes effect. Do you say "I'll gamble that I'll soon get cell phone communication so to heck with the suction, I'm walking." Or do you, for "insurance", whip out the Sawyer, spend a few minutes sucking out all you can get, and then heading back? I can tell you pretty confidently which of those two choices I'd take, regardless of the few minutes (maybe) wasted. If halfway back, I'm dragging and still no communication, and I hadn't given it a try, I'd have a hard time feeling like I did the right thing."

So, not only are you substituting your "common sense" for what the most current professional medical advice advises, but you are going to ignore the specific recommendations for the use of the extractor? As they say, common sense isn't.

http://www.nols.edu/wmi/curriculum_updates/archive/041105_sawyer.shtml

You may also enjoy this interview with one of the top experts in the field, who has authored more than 50 articles on evenomation, and specifically comments on the Sawyer issue:
http://www.kingsnake.com/articles/Feb28Bush.html

Or look at his site:
http://www.llu.edu/llumc/emergency/venom-er/safety.html



Post Edited (07-16-07 14:22)

KenM wrote:
> "Bites are NOT rare"

Is this really really true? Been hiking in Sierra for many moons and
have seen LOADS of Rattle Snakes. (including in LYV and along
Merced River Canyon almost every time been thru there).
Also I have never heard any PCT hikers saying any of their
compadres got bit or heard of people being bit.

The other thing I've heard is that most people get bit above the
knee... i.e. their asking for it.

I'm thinking like most things... fear has spread thru the community...

Comments?

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Everything I know I learned from

Bill, it is true, in the context of generally. Although dated, this gives you an idea of numbers, and more current data is about the same.

"Findlay E. Russell writes in Ann Rev Med 1980, 31:247-59.:

"Although there are an estimated 45,000 bites by all snakes in the United
States each year, only about 6680 persons are treated for snake venom
poisoning. However, it can be expected that at least 1000 additional
bites by venomous snakes occur each year and that they are either not
treated or go unreported. During the past five years, the number of
deaths from snakebite in the United States has ranged between 9 and 14.
Most of the deaths occurred in children, in the elderly, in untreated,
mistreated, or undertreated cases, in cases complicated by other serious
disease states, or in members of religious sects who handle serpents as
part of their worship exercises and refuse medical treatment. Almost all
reported deaths have been attributed to rattlesnakes."

======================

In contrast, what you say is also true about rarity *in backpackers*:

"The degree of protection afforded by responsible behavior and protective
clothing (boots, long pants) is remarkable. Iserson in JAMA reported on
the incidence of snakebite in three groups of experienced outdoor
workers. Members of the Southern Arizona Rescue Association worked
115,000 person-hours in the field without a snakebite. The personnel at
the La Selva Biological Station in Costa Rica (habitat of the fer de
lance, a venomous crotalid) worked for 350,000 person-hours in the field
without a bite. The graduate students at the Organization for Tropical
Studies, also in Costa Rica, worked 660,000 person-hours in the field
with only one bite.


Russell ( Emergency Medicine, 1990, 22:21-43.), has something to say about this as well, "Few bites occur in backpackers, serious hunters, or fishermen...In the past 20 years (written in 1990), there has been only one backpacker in the Sierras of California, who I know of, who was bitten by a rattlesnake, and this happened when he was changing a tire at the end of his hike."



Post Edited (07-10-07 21:25)

A couple of further suggestions if you get bit by a rattlesnake. First, remove all rings. Once your finger start to swell, you won't be able to get them off and ganggreen can set in within 4 hours when the circulation gets cut off. Also, I was told not to put any part of the extremity in ice. I was told ice or cold water on a snake bite was one of the worse things to do. I don't know the reason for this. It seems to go against logic.

On another note, I signed the petition regarding the North Pines campground and now my email is receiving all kinds of petition requests. I wished I hadn't used my real email.

GTS

GTS, thanks for the information. I think the idea behind not using ice may be similar to not constricting bloodflow with a tourniquet etc., in that it's supposed to be better to disperse the toxin throughout the bloodstream rather than having it concentrated in one area (where the stronger concentration might cause more damage, like loss of a limb).

Ken, I don't dispute that the best remedy for snakebite is to get to an emergency room or other medical help...my question was what to do in the event that it was not possible to do so, or if it would take a very long time, was there anything that should be done in the meantime, or instead if necessary.

The "seek professional medical help" answer is like telling someone that the best remedy for mountain lion attack is to not hike alone. That is fine, but in the event I'm hiking alone and am attacked, I still prefer to have an idea of the best course to take (and "don't hike alone" is not the answer, just as "get professional medical help" is not the answer to what I asked).

Perhaps the reason is that no one really knows what should be done, other than find a doctor. However, the suggestions (if they have explanations included) of what NOT to do are helpful also. One seeming contradiction is that the "bitee" is advised to rest, yet if they are alone or with someone who can't carry them out, advised to hike out. You can't do both. And the Sawyer extractor? Well, some say it is a good thing to use, others not, so you accept the advice from whoever you respect most, or who explains it best. Advice coming from a medical professional is not infallible, I won't begin to mention examples (or for that matter, a TV snake guy who hasn't been bitten, and always has a crew and communication available). If I see the extractor sucking out venom, I'd have to assume that's good; if not, or I have to sit there for an hour to get one drop, maybe it's not the best procedure and the time would be better used in resting or getting out. It worked on a wasp sting, but perhaps a snake bite is deeper and wouldn't work so well. I'll probably never know, since I don't plan to get bitten, and the odds are pretty good.

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Gary
Yosemite Photo Galleries: http://www.pbase.com/roberthouse/yo

If I were bitten a few days from help I would set up camp and lay down with a good supply of water on hand if possible. Whatever is going to happen to me will probably be less severe than what would happen if I tried to hike out for two or three days. Even if you had a hiking partner things would be pretty much the same as being solo. Help is still a few days away. If you start hiking and you get into a state of delirium you will probably get a fall injury to boot.

My dozen or so close calls with rattlers have me convinced that unless you step on one you will not get bit.

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Old Dude

Gary, I absolutely understand what you are asking. I understood it the first time.

I get the feeling that your assumption is "there must be SOMETHING that I can do that will affect the outcome". But the problem is, that there is actually nothing, except to avoid things that make things worse.

Hey, sometimes life is not the way that we want it to be. Logic looking out over the ocean tells us the planet is flat, eh?

The other confounding variable is that you, as does everyone, has access to a mountain of information on the internet. Some of it WAS the recommended way, but has been disproved. Some of it was suggested, but didn't pan out. Some of it is hopelessly outdated, even if from an authoritative source. So the problem is, what source do you believe?

I can point you to sources that are highly reputable, that are the sources that physicians all over the US call, if they are dealing with a case and they haven't before. People who have been involved with thousands of cases, and have written the papers and books that all others look to.

But, if you take the position that the medical profession doesn't know what to do, that will never convince you. Nothing ever will. However, if you do take that position, then you cannot cite medical information as your source for doing something. Can't have it both ways.

It seems that you are incredulous that a medical device is on the market that is not effective. In my career, I've endured many such devices. People THOUGHT they worked, so they used them. After getting widespread experience, it was found they did not. Should we still use them? I say no.

As for just sitting it out, I don't consider that irrational, however, it does not take into account that there are delayed problems that may develop. For example, infections are common, but don't show up for several days. If one waits, one has lost the opportunity to start treating. If you get to an ER in an hour, you will be treated with antibiotics and for tetanus, although THAT takes a week to develop. Remember that, although death is rare, permanent disability is common in the affected area, as high as 25%. The sooner one starts treating that, the better.

I'd start walking, in the hopes of encountering someone who could run for help to get me to a hospital.

Rattle snakes are common in the Sierras. It's not surprising you saw one. The chances of being bitten are slight unless you try to handle one. Two to three hours from help removes the medical threat unless you are very allergic. It's when you are two to three days from help that things can get tricky.

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Old Dude

AHHHH....the very reason I like this forum. Eventually, you will find good information from someone. A lot of guessing and speculation goes on here (including from me!), but usually not of the medical kind.

From what I've read on the topic in scientific and medical articles on the topic KenM did a very nice (and pretty respectful job) of debunking some of the myths out there. It's been well-established for several decades that attempting to suck out the venom and/or applying a touniquet is not helpful in any way. I never considered the dilution of the venom by letting it work its way through the body instead of trying to localize it, but it makes sense to me. If I ever get bit, eventually I want to see a medical doctor. So the sooner the better seems to be sound advice.

All things considered from the many posts above, I think I'll print Ken's initial response and put that in my backpack. It seems like good advice to me over "making it up as I go."

Again, a great forum for this and many other similar threads.

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Bill