Fatal bites from non-venomous snakes

[stephanbakir]

Mdt, I PMd you a while ago.

Sny ideas why my tongue kept slaughing for years after the reaction?

[MDT]

Originally Posted by stephanbakir

Mdt, I PMd you a while ago.

Sny ideas why my tongue kept slaughing for years after the reaction?

Dude...I just checked my box..I got nothing. However....check yours

[bcr226]

I think I understand what the OP is trying to convey. A similar issue has been raised concerning firearms and knives.

It's not the bite or the wound that kills. Many people have died from non fatal gun shot or knife wounds because of a mental schism. Even though they may not need treatment or with treatment the wound is superficial, they still die because of shock, fear, etc.

On the flip side of it, there have been instances where immediately mortal wounds did not stop an assailant. Case in point is the Platt and Mattix shoot out in Miami Florida. Platt took a hit to the heart from a .38 special that should have incapacitated him and killed him within seconds. However, he continued to fight the FBI in the shoot out for several more minutes before succumbing to the wound.

I can see how some people who have such a fear of snakes might shut down after being bitten. It's not the bite that is killing them, but their own reaction to the bite. It's all pschycological (forgive the mangled spelling).

[rafal]

Thanks a lot to all of you! So my conclusion is that some people can die for various reasons from bites by non-venomous snakes, like allergy, vulnerability to even traces of venom (some amount of venom is even produced by snakes and lizards that we consider non-venomous), extreme fear, shock, etc. But it is highly improbable that a significant part (more than 10%) of 20 000 - 125 000 people dying each year (source: Epidemiology of Snakebites on Wikipedia) is due to pure shock because it would be noticed by doctors, researchers, etc.

[stephanbakir]

Ines of 10% I would believe it to be in the less then .1% category

[MDT]

Rafal...actually, no. The "vulnerability of trace amount of venom" would still be envenomation. If something squirts it into you, you've been envenomated. What happens next counts as morbidity or mortality from envenomation. Further, if you are"scared to death" because you got bit from a NON-VENOMOUS snake, you would've been scared to death from skydiving, winning the lottery, etc. Meaning, if your cardiac status was fragile enough for an external event to cause death (meaning a fatal, terminal arrhythmia), it cannot/should not be ascribed to the snake. I will contend that TRUE allergic reaction to venom is not significant....again, you have to be exposed to an antigen initially BEFORE you develop an allergy. So, unless you've been bitten by (for example) a copperhead before, you are likely not allergic to copperhead venom. You will however, experience all of the wonderful effects from a pit viper bite.....but doubtfully an allergic reaction.

Venom is a tissue destroying/neural altering mixture of badness. It evolved for a reason, to facilitate capturing prey. We are just the unlucky bystanders in this equation. You get bit, venom injected, and biochemically it does what it does, nothing more, nothing less.

@bcr226...gunshot wounds shouldn't be included in this. Again, if you die from fear...something else was going on. GSW produce trauma. If you bleed out, you have no oxygen carrying capacity to get oxygen to tissues. No oxygen to tissues, they die...you die. That shot to the heart would not have killed him in seconds. .38 ballistics are questionable, blood loss that would produce anoxia to the brain can (and often does) take 30, 60, 90, 120 seconds. You can perform several tasks in that period of time. A vast majority of the GSW (handgun) victims I've treated are walking/talking on arrival to the ED. Handgun wounds, unless a hit on the central nervous system, are very unreliable in stopping the fight.

[Zoo Nanny]

I have a question. You talk about the lack of allergic reaction to the bites and needing to be exposed to the venom at a previous time. What if you are bitten by a snake that eats fish and you are allergic to fish, would this be a possible cross contamination exposure to the fish with an allergic reaction? Also in the event that this were to happen is there a way that the ER doctors would even be able to determine this?

[MDT]

ZN...in short, highly unlikely. I guess if you were allergic to Blue Gill fish, and a water snake had just like 30 seconds prior eaten a Blue Gill, and had little bits of Blue Gill scales stuck between its teeth, then I guess you could have issues. In any event, an allergic reaction looks nothing like systemic effects of envenomation. If your ED doc can't differentiate between the two, it's time to go back to school.

[bcr226]

Originally Posted by MDT

@bcr226...gunshot wounds shouldn't be included in this. Again, if you die from fear...something else was going on. GSW produce trauma. If you bleed out, you have no oxygen carrying capacity to get oxygen to tissues. No oxygen to tissues, they die...you die. That shot to the heart would not have killed him in seconds. .38 ballistics are questionable, blood loss that would produce anoxia to the brain can (and often does) take 30, 60, 90, 120 seconds. You can perform several tasks in that period of time. A vast majority of the GSW (handgun) victims I've treated are walking/talking on arrival to the ED. Handgun wounds, unless a hit on the central nervous system, are very unreliable in stopping the fight.

Actually, they do need to be included. An example of why is when someone grazes their hand with a .22, receives minimal blood loss but dies of shock. Concerning the Platt incident, the .38 round entered under his armpit, tore through the aortic chambers of his heart after passing through one lung and through the other to lodge in the muscle around his rib cage. According to the PM, He should have been out of the fight within 30 seconds. He wasn't. He continued the fight for some time.

Basically, what I'm saying is that I don't believe it's a function of the bite in the case of a non-venomous snake that is the likely cause of death but shock or mental inability to handle the fact of the bite. This has cross over to many other types of injuries. I've seen people faint from paper cuts or just the sight of blood. When something happens that has a large deal of misinformation or simply unknown information like a snake bite to many people, they instantly shut down thinking that it's a. venomous and b. fatal. So it may have a severe effect on the survivability factor of the incident.

[Zoo Nanny]

Originally Posted by MDT

ZN...in short, highly unlikely. I guess if you were allergic to Blue Gill fish, and a water snake had just like 30 seconds prior eaten a Blue Gill, and had little bits of Blue Gill scales stuck between its teeth, then I guess you could have issues. In any event, an allergic reaction looks nothing like systemic effects of envenomation. If your ED doc can't differentiate between the two, it's time to go back to school.

Thank you for the info.

[MDT]

Dying of "shock" bc you were bitten by a garter snake or grazed by a .22 is not the same as dying from exsanguination or hemodynamic collapse from either a GSW or bite. It's just not. The passing out that you mention after an injury is caused by a vagal nerve response. It's common. It would not generally be considered a fatal event. I'd really like to see case reports of someone who died from "shock" form a .22 "graze" wound. Autopsy report? Death certificate? Unless you were an 80 year old diabetic with cardiovascular disease and predisposed to a cardiac event, the average Joe isn't gonna die from a vagal response.

I know the ballistics from the gun fight you're talking about. I supported our county SWAT as a tactical medical officer...I've seen and dealt w many GSW's in my career. I've also treated anaphylaxis and pit viper envenomation. Loss of perfusion, whether that comes form bleeding out (GSW), respiratory failure (elapid bite), profound internal hemorrhage (pit viper) is the end result in its most extreme form...how long that takes is the variable.

[MDT]

Originally Posted by Zoo Nanny

Thank you for the info.

No problem