Avoid a $100,000 Medical Bill

This week’s guest columnist is Dr. Michael Johnson, a Family Medicine resident at the University Hospital and Clinics here in Lafayette.

In the Sportsman’s Paradise, enjoying the great outdoors means most of us have encountered a snake.  I remember when my father and I were squirrel hunting one evening on a creek bank.  I was following, literally in his footsteps, when he suddenly stopped.  He turned to me and said firmly, “Son, back up now.”  I looked down and saw he was standing on a snake he had accidentally walked on, and he wouldn’t move until I was safely away.  He then pinned the snake behind the neck with a stick, stepped off, and let it slither away.  This was the start of my lifelong hatred of snakes.

Between snakes and mosquitoes, it’s sometimes hard to enjoy Louisiana outdoors. Every year about 8,000 people are bitten by poisonous snakes in the United States, with 10-12 deaths.  Louisiana is home to four species of poisonous snakes: the rattlesnake, water moccasin (a.k.a cottonmouth), copperhead, and coral snake.  Most bites happen during summer and fall.  How can we keep children safe during this time of year without confining them to the prison of “inside the house?”

Parents can start by keeping kids from playing in tall grass or around large rocks.  These are the preferred environment for snakes.  It’s another incentive to mow the lawn, besides keeping up with the Jones’s.  Children shouldn’t play in vacant lots.  Use extreme caution when moving firewood or stacked lumber.  When outdoors, examine and then designate safe areas before fishing in ponds or swimming in lakes or creeks.

Never teach your kids that it’s alright to handle snakes.  This includes not letting them see their crazy uncle (we all have one) catch a snake to remove it, or worse, play with it. Dr. Hamilton had one partner, a life-long swamp rat, who did just that after his son found a snake in the yard.  Instead of staying away, he decided to show his son how to “walk” a snake with a forked stick.  He led the snake just far enough to get himself bitten.

What if you or your child fall prey to a poisonous snake’s fangs? We’ve been educated by John Wayne, the Duke himself, on wrapping a belt around your arm, cutting the bite with your bowie knife, and sucking out the venom.  In the movies this always saved his life, yet it’s another case where Hollywood shows us exactly what NOT to do.  Here’s what we SHOULD do.

After being bitten, first remove the victim from the snake’s territory. Snakes don’t always bite and slither away; sometimes they stick around and bite again.  Next, don’t panic.  Up to 25% of poisonous snake bites are “dry” bites, where the snake bites but doesn’t inject venom.  If you do get injected, it’s still okay.  The chance of dying from a snakebite is nearly zero in the United States because of high-quality medical care.

After calming the victim (and yourself), keep him or her warm and quiet.  Immobilize the injured part with a splint and remove watches, rings, or tight clothing from the affected extremity.  Swelling around these might cut off circulation.  Do NOT apply tourniquets or tigtht dressings.  Loss of blood to the bitten part causes more damage than good. Clean the wound with water.

Attempt to identify the snake, as long as that doesn’t endanger anyone. Take a picture from a safe distance.  Don’t handle the snake even if it’s dead, since dead snakes can still bite reflexively.  Don’t try to kill the snake. Many snake bites are from non-poisonous snakes, and killing them gives the rats one less predator to worry about.  And if you try to kill it and get bitten yourself, that’s one more victim to worry about.  Most of all, don’t delay transport just to identify the snake.  Lay the patient down and get going!

How does this add up to a $100,000 medical bill?  If anti-venom is needed, treatment takes 6-10 vials, each vial costing about $7500.  Add that to the cost of a hospital stay. I’d rather spend that hundred grand on a yacht or a round-the-world trip.  So don’t be that person who plays with snakes; be the safer, more educated person with a yacht.