James W. Grier of North Dakota State University (see Suggested Reading list) has developed an easy-to-remember "2-3-4" guideline for poisonous snakebite: 2 points for avoiding or minimizing the chances of being bitten, 3 things that SHOULD be done in case of poisonous snakebite, and 4 things that SHOULD NOT be done. This "2-3-4" guideline along with additional information from other sources was adapted for Nebraska. An article by Keith Sutton that appeared in Arkansas Game and Fish magazine (May/June issue, 1987) provided excellent information on avoiding poisonous snakebite, and the Mid-Plains Poison Control Center in Omaha, Nebraska helped with information on first aid.

Avoiding Poisonous Snakes - The "2"

1). NEVER HANDLE OR MEDDLE WITH A POISONOUS SNAKE -- this is dangerous for both you and those around you. Nearly one third of all snake bites reported in the U.S. are made by captive snakes. Be aware that killed snakes and even separated snake heads can bite for some time through reflex action. In fact, rattlesnake heads that were frozen or dried and mounted into tie tacks have caused poisonings when someone caught a finger or thumb on a fang.

Because children are small in size and naturally curious, they are susceptible to snakebite. To play it safe, instruct your children never to handle or go near snakes without the supervision of a knowledgeable and responsible adult.

2). ALWAYS BE ALERT, CAUTIOUS, AND PREPARED when in areas with poisonous snakes.

• Be attentive outdoors. Nebraska's poisonous snakes are naturally camouflaged. Before traveling in areas where poisonous snakes occur, use common sense in choosing foot and leg wear -- for example, wear high-top boots and loose-fitting trousers.
• When walking or climbing, place your hands and feet only where you can see. Be especially careful when stepping over or around logs or rocks, gathering firewood, crawling under fences, or reaching up over ledges.
• When camping, use a tent with a floor and zippered door, and camp in open areas such as patches of short grass or wide rock slabs that don't have snake hiding places. If you have no tent, try sleeping on a cot or picnic table.
• Before sitting down outdoors, look around carefully.
• Gather firewood before dark.
• Finally, understand where snakes are likely to be. Snakes are "cold-blooded," which means their body temperature varies with conditions around them. On hot days, they will be in shaded spots. On cool days, they need to warm up, so they will be sunning on rocks or maybe right on a road or trail. At nightfall, snakes are sometimes attracted to a paved road surface where they are warmed by heat radiating from the road. So use caution when walking or jogging on warm roads at night.

What SHOULD be done in case of Poisonous Snakebite - The "3"

The chance of being bitten by a poisonous snake is extremely small and death from snakebite is even rarer. In the United States, more people die from lightning than from snakebite. Also, it is estimated that about 20 percent of poisonous snakebites have no venom injected -- these are known as "dry bites." However, snakebites do happen, so you should think ahead before venturing where poisonous snakes occur. Medical understanding of what to do about poisonous snakebite has improved in recent years. Some earlier first aid techniques that you may have heard about are no longer recommended and may even be harmful.

In case of poisonous snakebite, you should focus on remaining calm and getting the victim safely to a hospital, rather than on doing something in the field. One doctor who has treated many snakebites commented that the best first aid kit for snakebite is a set of car keys.

1). STAY CALM. Think -- put your mind in control so you remain as calm as possible. The snake may be nonpoisonous and, if it is poisonous, it's best to stay calm. If you are with a snakebite victim, your response should be calm and reassuring for the bitten person. Keep the victim comfortable and the bitten area immobilized as much as possible. Because swelling may occur, remove rings, watches, and other bands near the bite.

2). GET TO A HOSPITAL/PHYSICIAN AS QUICKLY AND SAFELY AS POSSIBLE. It's best to know the name, location, and telephone number of the closest hospital before you go into the field in an area where poisonous snakes occur (see wallet-size cut-out card). Carry or help the victim to a vehicle, then drive to a hospital. If you are alone when bitten, walk slowly and calmly to a vehicle, with occasional stopping and resting. Call ahead to the hospital, if you can without wasting time, to alert them that you are coming. When you call or at the time of arrival, ask if they have experience with bites. If not, or if they need further information, suggest that they call the MID-PLAINS POISON CONTROL CENTER in Omaha, Nebraska, for advice on proper treatment.

Don't worry about killing the snake. The person trying to kill the snake might get bitten, and having the dead snake will not help with treatment. In addition, trying to locate and kill the snake uses time and may cause the victim to be too active. And, even a killed snake can bite for some time through reflex action. Questions about whether the snake is poisonous will be established within a few minutes because poisonous snakebite causes pain and swelling at the site of the bite. Two fang marks will also show at the bite (all snakes have teeth; only poisonous ones have fangs). If you think you've been bitten by a poisonous snake but have no symptoms, it's best to be safe and go directly to a hospital anyway.

3). MID-PLAINS POISON CONTROL CENTER. Most medical centers in locations where poisonous snakes occur have information and experience on what to do for snakebites. If they do not, or you otherwise end up with a situation in which the medical personnel wish to consult, have them contact the Mid-Plains Poison Control Center located in Omaha, Nebraska. The phone number is on the cut-out card and service is available at all times, 24 hours/day. If you don't have the number during an emergency, simply call the telephone information operator for Omaha.

What SHOULD NOT Be Done - The "4"

1). DO NOT GIVE ALCOHOLIC BEVERAGES to the victim. Drinking and poisonous snakes don't mix -- many snakebite accidents involve persons who had been drinking. Use of alcohol after a bite may complicate the situation in general and increase the circulation and distribution of the poison.

2). DO NOT COOL the bitten area. Cooling with ice packs or by immersing in cold water was recommended for a few years by some persons. However, it led to numerous problems, including a number of unnecessary amputations.

3). DO NOT USE A TOURNIQUET. Like cooling, tourniquets cause problems and can lead to unnecessary amputations. They restrict circulation into the region, which reduces both the body's ability to fight the poison naturally and also deprives the tissues in the area of necessary oxygen and circulatory supplies.

4). DO NOT CUT into the bitten area. The old incision and suction method is no longer generally recommended for most cases of snakebite, although there is still some difference of opinion on the matter. Unless it is done by someone with formal training and proper equipment, and is initiated immediately (within a maximum of five minutes of the bite), it is ineffective and can be worse than the bite itself. It is the cutting that is dangerous.

Should You Kill Poisonous Snakes on Sight?

Poisonous snakes are dangerous when nearby because of their bite, so killing them when found near a home or populated area is certainly justified. In other areas, however, it's usually best just to leave them alone. Trying to kill a poisonous snake may result in someone being bitten, and the snake that from a distance looked like a poisonous one, may in fact be a similar-looking harmless type. Also, even poisonous snakes have a role in nature and their poisons hold secrets that people need. For example, one snake poison led to an important medicine for high blood pressure, and others are being studied for applications in preventing pain, treating blood and heart problems, and controlling harmful bacteria. And snakes are one of nature's best mousetraps -- they kill and eat rats, mice, gophers, young prairie dogs, and other animals that are often considered pests. So when thinking about killing, use your best judgement, but give the snake the benefit of a second thought.

Suggested Reading

Identification Guides

Other Useful References

Grier, J. W. 1987. SNAKEBITE. North Dakota Outdoors, March 1987, Number 8, pages 2-7. An excellent summary of snakebite information, portions of which are included in this NebGuide. It includes an annotated list of references related to poisonous snakes and snakebite.

Grier, J. W. ~1988. SNAKES AND THE PROBLEM OF SNAKEBITE. Unpublished guide. Zoology Department, North Dakota State University, Fargo, ND 58105. 6pp. An outstanding overview of snakebite information, including the "2-3-4" of snakebite and some information on snakes other than pit vipers.

Lynch, J. D. 1985. ANNOTATED CHECKLIST OF THE AMPHIBIANS AND REPTILES OF NEBRASKA. Transactions of the Nebraska Academy of Science 13:33-57. Includes excellent maps that show locations where Nebraska snakes are known to occur, along with some information on identification and abundance.

Sutton, K. 1987. ARKANSAS' VENOMOUS SNAKES, THE SERIOUS SIX. Arkansas Game and Fish, May/June, 1987, Vol. 18, No. 3, pages 13-21. An interesting overview of poisonous snakes and snakebite problems in Arkansas. It includes an excellent section on how to avoid snakebite, portions of which are included in this NebGuide. Single reprints are available at no cost from Arkansas Game and Fish, Information and Education Division, 2 Natural Resources Drive, Little Rock, AR 72205.

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