SNAKES

There are several species of rattlesnakes identified in Missouri. A pit viper snake has a heat sensing "pit" located between the nostril and eye on each side that is used to locate and trail prey. Rattlesnakes can grow up to six feet in length. Baby rattlesnakes are capable of a venomous bite from birth. Nonpoisonous snakebites are not considered serious and are generally treated as minor wounds; only poisonous snakebites are considered medical emergencies.

Symptoms generally occur immediately, but only about one third of all bites manifest symptoms. When no symptoms occur, probably no venom was injected into the victim. In 50 percent of coral snake bites, no venom is injected because the coral snake has to chew the skin for envenomation to occur. In as many as 25 percent of all venomous pit viper bites, no venom is injected, possibly because the fangs may be injured, the venom sacs may be empty at the time of the bite, or the snake may not use the fangs when it strikes. Poisonous snakebite venom contains some of the most complex toxins known; venoms can affect the central nervous system, brain, heart, kidneys, and blood.

Signs that indicate a poisonous snakebite include:

The bite consists of one or two distinct puncture wounds. Nonpoisonous snakes usually leave a series of small, shallow puncture wounds because they have teeth instead of fangs. The exception is the coral snake, which leaves a semicircular marking from its teeth. Because some poisonous snakes also have teeth, fang and teeth marks may be apparent. The presence of teeth marks does not rule out a poisonous bite, but the presence of fang marks always confirms a poisonous snakebite.

Characteristics of pit viper snakes:

• Large fangs; nonpoisonous snakes have small teeth.
• The two fangs of a poisonous snake are hollow and work like a hypodermic needle.
• Pupils resemble vertical slits.
• Presence of a pit. Pit vipers have a telltale pit between the eye and the mouth. The pit, a heat-sensing organ, makes it possible for the snake to accurately strike a warm-blooded victim, even if the snake cannot see the victim.
• A triangular or arrowhead shaped head.
• The rattlesnake often shakes its rattles as a warning. BUT NOT ALWAYS!

One snake that is not a pit viper snake but is poisonous is the coral snake. The coral snake is highly poisonous and resembles a number of nonpoisonous snakes. Coral snakes, as proteroglyphous elapids, have fixed fangs as opposed to retractible fangs. Because its mouth is so small and its teeth are short, most coral snakes inflict bites on the toes and fingers. They have to chew the skin a while to inject venom. Coral snakes are small and ringed with red, yellow, and black. The chances for recovery of a snakebite are great if the patient receives care within two hours of the bite.

You can decide how serious the bite is by considering several factors:

• The age, size and general health of the patient. A small child will probably react much more severely to a smaller amount of venom than will an adult. Bites are most dangerous in children and the elderly.
• The depth, location and number of bites. A single, glancing blow by the fangs is much less dangerous than multiple wounds or wounds that penetrate the flesh deeply. A bite that penetrates a blood vessel is extremely dangerous. The least dangerous bites occur on the extremities and in fatty tissue. Bites on the head or trunk are usually fatal.
• The duration of the bite. The longer the bite, the greater the amount of venom that may be injected into the patient's system.
• Clothing. A snake that bites through several layers of clothing will not leave as much venom as a snake that strikes bare skin.
• Maturity, type, and size of the snake. Small snakes usually do not produce enough venom to seriously harm an adult.
  
• Condition of the fangs and venom sacs. More venom will be injected if the fangs and venom sacs are in good condition.
  
• How angry or fearful a snake is. More venom will be injected if the snake is angry or fearful.

Treatment for snakebite:

The severity of a pit viper bite is gauged by how rapidly symptoms develop, which depends on how much poison was injected. Signs and symptoms of a pit viper bite include:

1. Immediate and severe burning pain and swelling around the fang marks, usually within five minutes. The entire extremity generally swells within eight to 36 hours.
2. Purplish discoloration around the bite, usually developing within two to three hours.
3. Numbness and possible blistering around the bite, generally within several hours.
4. Nausea and vomiting
5. Rapid heartbeat, low blood pressure, weakness, and fainting
6. Numbness and tingling of the tongue and mouth
7. Excessive sweating
8. Fever and chills
9. Muscular twitching
10. Convulsions
11. Dimmed vision
12. Headache

The priorities of emergency care for snakebite are to maintain basic life support - airway, breathing and circulation - and limit the spread of the venom and to transport the patient without delay.

1. Move the patient away from the snake to prevent repeated bites or bites to yourself. Snakes cannot sustain prolonged rapid movement so are often within a 20 foot radius of where the bite first occurred.
2. Have the patient lie down and keep him quiet. Reassure him to slow the metabolism and subsequent spread of the venom.
3. Cut and suck methods are useless. According to one study, the most you can get is six percent of the venom. Many people do far more damage when they cut than they do good.
4. Keep the bitten extremity at the level of the heart.
5. Remove any rings, bracelets or other jewelry that could impede circulation if swelling occurs.
6. Clean the wound gently with alcohol, soap and water, hydrogen peroxide or other mild antiseptic.
7. Do not cool or chill or apply ice.
8. Do not attempt to tie any type of tourniquet or constricting bands.
9. Transport the patient as soon as possible to the hospital. Signs and symptoms of a coral snake bite are different than those of a pit viper. Rather than leaving two distinct fang marks, the coral snake leaves one or more tiny scratch marks in the area of the bite. There is little pain or swelling and the patient's tissue usually does not turn black and blue. Usually, there is no pain or swelling at the bite site. However, one to eight hours after the bite, the patient will experience blurred vision, drooping eyelids, slurred speech, increased salivation and sweating. Emergency care for a coral snake bite is similar to that for a pit viper snake bite.

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INSECT / SPIDER BITES

The normal reaction to an insect sting is a sharp, stinging pain followed by an itchy, swollen, painful raised area. The swelling may be there for several days but usually goes away within 24 hours. Local reactions are rarely serious or life-threatening and can be treated with cold compresses.

However, there are some people who have allergic reactions to "normal" insect stings. Approximately 50 people die each year in the United States from insect stings. This is more than all other bites combined including snakebites. Thousands of people are allergic to bee, wasp, and hornet stings. Insect stings can be deadly for those people, on the average, within 10 minutes of the sting but almost always within the first hour.

The stinging insects that most commonly cause allergic reactions belong to a group of the hymenoptera, the insects with membranous wings. These include bees, wasps, hornets, and yellow jackets. Stings from wasps and bees are the most common.

Black Widow Spider
The black widow is a spider with a shiny black body, thin legs and an hourglass shaped red/white mark on its abdomen. The female is much larger than the male and is one of the largest spiders in the United States. Males generally do not bite. Females bite only when hungry, agitated or protecting the egg sac. The black widow is not aggressive. They are usually found in dry, secluded, dimly lit areas. More than 80 percent of all bite victims are adult men.

Black widow spider bites are the leading cause of death from spider bites in the United States. The venom is 14 times more toxic than rattlesnake venom. It is a neurotoxin that causes little local reaction but does cause pain and spasms in the larger muscle groups of the body within 30 minutes to three hours. Severe bites can cause respiratory failure, coma and death.

Those at the highest risk are children under age 16, the elderly, people with chronic illness and people with high blood pressure. Signs and symptoms of a black widow spider bite:

1. A pinprick sensation at the bite site, becoming a dull ache within 30 to 40 minutes
2. Pain and spasms in the shoulders, back, chest, and abdominal muscles within 30 minutes to three hours
3. Rigid, boardlike abdomen
4. Restlessness and anxiety
5. Fever
6. Rash
7. Headache
8. Vomiting and nausea
9. Flushing
10. Sweating
11. Grimacing

The symptoms usually last 24 to 48 hours. Treatment:

1. Treat for shock
2. Apply a cold compress but do not apply ice
3. Transport to hospital as quickly as possible

Brown Spiders
There are two types of brown spiders or brown recluse spiders in Missouri. They often are called violin spiders because of the characteristic "violin-shaped" marking on the upper back. They are generally brown but can range in color from yellow to dark brown. They are timid with webs in dry undisturbed areas.

The bite of the brown spider is a serious medical condition. The bite is nonhealing and causes tissue death. Sometimes surgery is necessary. The bite causes only a mild stinging sensation if any at all. Victims often are unaware they have been bitten. Several hours after the bite, the following signs and symptoms begin to result:

1. A small white area appears surrounded by a margin of redness which may produce a mild itching pain.
2. A blister appears surrounded by mild swelling and redness.
3. A "bulls-eye" or "target" lesion develops
4. There may be fever, chills, rash, hives, nausea and pain in the joints over the next few days.

The target lesion will enlarge over the next few days and produce extensive tissue death. There is no antivenom. The lesion will have to be soaked in antispetic and possibly antibiotics. Surgery may be necessary to cut out the dead tissue.

Scorpions
There are many species of scorpions found in Missouri but only one is potentially lethal. This is the bark scorpion. It is one of the smaller species being one to one and a half inches long. It prefers places dark and cool, wood piles, palm trees, decorative bark. The severity of the sting depends on the amount of venom injected but scorpion stings can be fatal. Ninety percent of all scorpion stings occur on the hands.

The lethal scorpion is very slender and streamlined. It is straw-colored or nearly opaque, small, less than two inches long. Signs and symptoms of scorpion stings include:

1. Sharp pain at the site of the sting
2. Swelling that gradually spreads
3. Discoloration
4. Nausea and vomiting
5. Restlessness
6. Drooling
7. Poor coordination
8. Incontinence
9. Seizures

Treatment:

1. Apply ice to relieve the pain of the sting
2. Be sure the victim's airway stays clear
3. Transport to a hospital. A specific antivenom is available.

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AFRICANIZED HONEY BEES

Africanized honey bees are the temperamental cousin of the more common European honey bee found in Arizona. They often are called "killer bees", but in reality their stings are less potent and painful than the common bee sting. Contrary to portrayal in the movies, these bees do not swoop down in mass causing death and destruction. They do defend their nesting sites very aggressively, sometimes stinging their victims hundreds of times.

It is impossible for the average person to tell the difference between an Africanized honey bee and the common European honey bee. Only an expert with sophisticated lab equipment is able to distinguish between the two. Those at highest risk are individuals who are allergic to bee stings and pets that are penned or tied up near honey bee hives.

Do's and Don'ts

• DO check your property regularly for bee colonies. Honey bees nest in a wide variety of places, especially Africanized honey bees. Check animal burrows, water meter boxes, overturned flower pots, trees and shrubs.
• DO keep pets and children indoors when using weed eaters, hedge clippers, tractor power mowers, chain saws, etc. Attacks frequently occur when a person is mowing the lawn or pruning shrubs and inadvertently strikes a bee's nest.
• DO avoid excessive motion when near a colony. Bees are much more likely to respond to an object in motion than a stationary one.
• DON'T pen, tie or tether animals near bee hives or nests.
• DON'T destroy bee colonies or hive, especially with pesticides. Honey bees are a vital link to U.S. agriculture. Each year, pollination by honey bees add at least $10 billion to the value of more than 90 crops. They also produce about $150 million worth of honey each year.
• DON'T remove bees yourself. If you want bees removed, look in the yellow pages under "bee removal" or "beekeepers".

What to do if you are attacked:

1. Run as quickly as you can away from the bees. Do not flail or swing your arms at them, as this may further annoy them.
2. Because bees target the head and eyes, cover your head as much as you can without slowing your escape.
3. Get to the shelter or closest house or car as quickly as possible. Don't worry if a few bees become trapped in your home. If several bees follow you into your car, drive about a quarter of a mile and let the bees out of the car.

When to call the Fire Department:
Call the fire departament only when emergency medical services are needed. If someone has been stung by many bees at once or has an allergic reaction to a bee sting, call 9-1-1. Call the fire department if someone has become trapped in a building or car with lots of bees. Fire trucks are equipped with a foam that can be sprayed on the bees to drown them. DO NOT call the fire department to remove bee colonies or hives. If you want bees removed, look in the yellow pages under "bee removal" or "beekeepers".

How to treat stings from Africanized bees:
Treating stings from Africanized bees is much the same as treating a common bee sting. If a person is stung:

1. Keep the affected area below the heart
2. If the sting was by a bee and the stinger is still in the skin, remove it by gently scraping against it with your fingernail, a credit card or a knife. Be careful not to squeeze the stinger. The venom sac still will be attached and you will inject additional venom into the area. Be sure to remove the venom sac.
3. Apply cold compresses to relieve pain and swelling but do not apply ice directly.
4. If it becomes difficult to breathe, call 9-1-1. Itching should quit within a few hours. If it persists beyond two days, or if signs and symptoms of an allergic reaction occur after an insect bite you should be seen by a doctor. The signs and symptoms of an allergic reaction include:
   
   
   1. Burning pain and itching at the bite site
   2. Itching on the palms of the hands and soles of the feet
   3. Itching on the neck and the groin
   4. General body swelling
   5. A nettlelike rash over the entire body
   6. Difficulty breathing
   7. Faintness, weakness
   8. Nausea
   9. Shock
   10. Unconsciousnes