Rattlesnake Bites: What to Do, and What Not to Do

A rattlesnake bite is a medical emergency every time. Not sometimes, not
depending on how it looks — every time. Go to an emergency room, or call 911.

That is the whole answer, and if you are reading this because it just happened,
stop here and go. The rest is for the drive, or for before it ever happens.

Why "wait and see" is the wrong instinct

A rattlesnake bite often looks underwhelming in the first few minutes. Two small
punctures, some bleeding, pain that seems manageable. People talk themselves into
waiting.

The problem is that venom keeps working. Swelling advances up the limb over
hours, tissue is damaged as it goes, and the effects on blood clotting can take
longer still to show up. Treatment is far more effective early, and the decision
to go is best made before symptoms make it for you.

Deaths are rare, and that is not a reason to stay home. The most frequently
cited estimates, as Arizona's Poison Center reports them, put venomous
snakebites in the United States at around 8,000 a year, typically resulting in
eight to fifteen deaths, with the recent death rate under one per cent. The
Center's own conclusion from those same numbers is that serious symptoms remain
possible and bite victims must be seen at a medical facility without delay.
A low death rate is what treated bites look like. It is not what an untreated
one looks like.

Arizona has fifteen different kinds of rattlesnake, and every one of them is
venomous. Bites here are not exotic — and which kind bit you does not change
what is done about it.

What to do

1. Move away from the snake. It can bite again, and going back to deal with
   it only delays getting to hospital.
2. Call 911, or get to an emergency room now. If the person is alone,
   dizzy, or a long way from a car, 911 is the better call.
3. Sit or lie down and stay as still as practical. Calm reduces circulation
   of venom; panic and exertion increase it.
4. Keep the bitten limb roughly level with the heart — not raised high, not
   hanging down.
5. Take off rings, watches, bracelets and tight shoes immediately, before
   swelling starts. This one matters more than people expect: a ring left on a
   swelling finger becomes a tourniquet nobody chose.
6. Mark the edge of the swelling with a pen and write the time next to it.
   Repeat every fifteen minutes or so. This gives the ER team a picture of how
   fast it is advancing, which is genuinely useful clinical information.
7. Note the time of the bite if anyone can.
8. Let someone else drive, or wait for the ambulance.

What not to do — all of these make it worse

• Do not apply a tourniquet, or any tight band. Concentrating venom in one
  limb increases tissue damage rather than protecting the rest of the body.
• Do not cut the wound or try to suck out venom. It removes almost no venom
  and adds a wound plus an infection risk.
• Do not use a suction device or "snake bite kit." They do not work.
• Do not apply ice. Cold worsens the tissue injury.
• Do not drink alcohol or take anything to "thin the blood."
• Do not take ibuprofen, aspirin or naproxen if avoidable — bleeding is
  already a concern with rattlesnake venom. Paracetamol/acetaminophen is the
  safer choice if something is needed.
• Do not try to catch, kill or bring the snake. Identification does not
  change the treatment, and people get bitten a second time doing it. A photo
  from a safe distance is more than enough, and even that is optional.
• Do not handle a dead one either. A dead venomous snake can still strike by
  reflex and still inject venom, for several hours after it dies.
• Do not wait to see if it gets worse.

Arizona's Poison Center compresses the whole of this into one line: the best
first-aid kit for a snakebite is your car keys and your phone. Field first aid
mostly adds a second injury. Getting there is the treatment.

What happens at the ER

You will be assessed quickly, the limb will be measured and marked so the team
can track the swelling, and blood tests will look at clotting. Antivenom is
given based on how the bite is progressing rather than automatically, and that
judgement is the reason this belongs in an emergency room rather than at home.

El Mirage ER is a full-scope emergency room with CT, X-ray and a full lab on
site, and a board-certified physician sees every patient. If someone
needs to be admitted to hospital afterwards, we treat and stabilise them here
and arrange the transfer.

Dry bites, and why they do not change the advice

Some rattlesnake bites are "dry" — a bite with little or no venom injected. It
happens often enough to be worth knowing about, and the reported proportion
varies enough between sources that no single percentage belongs on this page.
That sounds reassuring until you notice the catch: you cannot tell early on.
A dry bite and a serious envenomation can look identical in the first fifteen
minutes. The only way to know is observation by people who can treat it if it
turns out not to be dry.

So a dry bite is a diagnosis made afterwards, never a reason to stay home.

Avoiding one in the first place

Rattlesnakes are not looking for people. Bites happen when someone steps near
one without seeing it, or reaches into a space they cannot see.

• Watch where you put your feet and hands, especially around rocks, wood
  piles, and the base of shrubs
• Carry a light after dark. Snakes are more active on warm evenings, and
  paths and patios hold heat
• Wear closed shoes on trails and in the yard, not sandals
• Keep dogs on a lead on desert trails — a curious dog finds the snake first
• Do not step over a log or rock when you could step onto it and look first
• Give a rattling snake a wide berth. It is warning you. Arizona's Poison
  Center is blunt about this: these animals want to avoid people and will not
  attack, chase, or deliberately bite — so leaving it alone is the whole
  technique
• Light the outside of the house — yards, porches, sidewalks. It is on the
  Poison Center's own prevention list and it is the cheapest thing on it

When they are actually out. Reptiles in Arizona are most active from April
through October. In the hottest part of the summer they are mostly active at
night. In spring and autumn — or on a warm winter day, which the West Valley
gets plenty of — they turn up during daylight.

A snake in the yard is usually just passing through. That is the Poison
Center's read, and it is the answer to the question most people here actually
have. If you are worried about the one in your yard, have somebody qualified
remove it. Nobody in the house should be taking that job on.

Frequently asked

Should I drive to the ER or call 911?
Either is reasonable if a passenger can drive and the ER is close. Call 911 if
the person is alone, feels faint, has trouble breathing, or was bitten on the
face or neck.

What if my dog is bitten?
Straight to a veterinary emergency clinic. We treat people.

Is a baby rattlesnake less dangerous?
No. Smaller snakes are fully venomous and can be harder to spot.

The pain is not that bad. Do I still need to go?
Yes. Pain at the start does not predict how the bite will progress.

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If you have been bitten, come in now — El Mirage ER is open 24 hours a day,
7 days a week at 12000 N El Mirage Rd, no appointment and no referral. Call
(480) 237-4922 if you need us, and call 911 instead if the person cannot
travel safely or is getting worse quickly.

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Sources

The guidance in this article about when to seek emergency care is drawn
from these public sources. Each one is linked so you can read it yourself.

• Arizona Poison and Drug Information Center — Rattlesnakes — https://azpoison.com/venom/rattlesnakes
• Poison Control (National Capital Poison Center) — Poison Help, 1-800-222-1222 — https://www.poison.org/

This article is general information, not a diagnosis, and it cannot account
for your history or medications. If you are unsure, call us on (480) 237-4922
or come in. If it might be an emergency, treat it as one and call 911.