Posted by & filed under Authorized, News.

By Elizabeth Acquista, MD, FACS

Southeastern North Carolina is home to a wide variety of reptiles. Snakes are included in this group of cold-blooded animals. Snakes, both venomous and harmless, are amongst our reptilian neighbors. Snakes can be helpers in the garden by eating small creatures such as mice and rats that may be bringing tick-borne illnesses into our yards. Snakes do not hunt people, nor do they track or follow people. However, they will attack humans when they feel threatened. This threat is usually unintended by children playing, workers, or folks out in their gardens. Wild snakes should be avoided.

There are several species of venomous pit vipers and rattlers in Southeastern North Carolina. The Eastern coral snake (Micrurus fulvius) is one of the six venomous species of snakes of North Carolina. The Eastern diamond rattlesnake (Crotalus adamanteus), the timber rattlesnake (Crotalus horridus), the pygmy rattlesnake (Sistrurus miliarius), semi-aquatic cottonmouth (Agkistrodon piscivorus) snake, and possibly the most feared: the copperhead snake (Agkistrodon contortrix) also reside in our area. It is thought that over 90% of the snake bites in NC are delivered by the copperhead snake, which inhabits all of NC except the Outer Banks! The copperhead bite is exquisitely painful; however, it is very unlikely to cause a death.

At New Hanover Regional Medical Center, the Trauma team takes care of the small number of patients with severe envenomation. Most bites will cause a reaction at the site of the bite. Individuals with a reaction involving serious swelling can experience limitation in the range of motion of a swollen arm or leg.  Snake bite care is generally supportive, consisting of multiple examinations, lab tests and pain control. Antivenom is available, but is not given for all bites. A small number of people have reactions to the antivenom itself! Surgical interventions for snake bites are occasionally necessary, but this is uncommon. 

A snakebite can be painful and dangerous, and, in very, very rare cases, it can be deadly. In the overwhelming majority of people, snake bites cause intense pain, with swelling.  Snakes should be avoided.  If you see a snake in the yard, give it plenty of room, at least six feet.  NC Poison control (800) 222-1222 should be called in the event of a snake bite.  Do not try to catch or kill the snake. It is most important to get clear of the threatened animal and determine if you need medical attention. If there is extensive bruising, or any difficulty breathing, or if there is swelling of the throat after a snake bite, call 911 for emergency medical assistance.

Am Surg. 2010 Jul;76(7):755-8.  An evaluation of snake bites and antivenin use at a regional medical center.  Watson LI1, Spivey C, Menon CR, Kotwall CA, Clancy TV, Hope WW.

Elizabeth Acquista, MD earned the Doctor of Medicine Degree at the Royal College of Surgeons in Ireland and trained in Surgery and Trauma Surgery at New York Medical College, the University of Connecticut and UNC-Chapel Hill.  Dr. Acquista practices Surgery with NHRMC General Surgery Specialists and is an Assistant Professor of Surgery in the NHRMC Surgical Residency Program.