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New Supplier of Antivenom for Rattlesnake Bites-Now Available in ER

For many years, Veterans Memorial Hospital has not stocked the antivenom for rattlesnake bites for two reasons.  One, rattlesnake bites are extremely rare and two, the cost of keeping the antivenom on hand was astronomical at nearly $30,000 for an initial course of treatment.  Then whenever the antivenom outdates, a new course would need to again be purchased at that cost.  The hospital discontinued stocking the antivenom many years ago, as did many other Iowa hospitals, and made back-up plans to transfer any patients to larger facilities when and if the antivenom was needed.

Due to this summer’s dry conditions forcing more rattlesnakes to venture from their dens, there have been a few rattlesnake bites in the area.  Because of this, Veterans Memorial Hospital pharmacist, Brittney Snitker, began searching for alternative resources to allow the hospital to stock the antivenom once again.

Snitker, who is the hospital’s first own full-time pharmacist, researched options and found a supplier of the antivenom who will replace the vials free of charge when they do outdate.  The antivenom is currently available in the Veterans Memorial Hospital Emergency Department.

“While this medication is still very expensive, the free replacement policy makes it feasible for our small hospital to carry the product.  Living in our rural area, having this medication available on the rare occurrence a patient needs it, is very important,” states Brittney Snitker.  “Snakebite antivenom, works to stop the venom from spreading throughout the body and therefore reduce the associated complications a patient may experience.  The sooner a patient can receive that critical first dose, the better their outcomes will likely be.  At VMH we have the full initial dose that works against any venomous snake in North American.  Often, patients need multiple rounds of antivenom and close monitoring so after this initial dose, the patient will be transferred to another facility to provide this higher level of care and more rounds of antivenom if necessary.”

What to do if bitten by a snake?

In the rare occasion anyone is bitten by a rattlesnake, they should first of all remain calm and seek medical attention and remain as still as possible.  Do not handle the snake, even if it is dead, since the bite reflex may remain intact and could bite again.   Remove any jewelry or footwear from the affected extremity and clothing only IF it is tight fitting.   DO NOT apply pressure, tourniquets,  constriction dressings, or ice to the area.

Immobilize the injured body part in a functional or extended position at the level of the heart.  With lower extremity bites, do not allow the victim to walk or exert themselves as muscle contraction may increase snake venom absorption.  Do not manipulate the wound except for gentle bandaging or. If it will be some time before the victim reaches the medical facility, the wound can be gently washed.  Legs with bites can be splinted with any rigid objects available such as a tree branch, rolled newspaper, sleeping bag pad, backpack, etc.  Bites to the leg should be splinted posteriorly, extended straight with the ankle and the knee immobilized.  Splint the arm with the elbow bent and apply a sling tied behind the neck.  Be sure to withhold any alcohol and any drugs such as aspirin, Tylenol, Ibuprofen, etc.

Ross Geerdes is the Director of Allamakee County Conservation.  He shares the following facts and statistics on rattlesnakes.  “Iowa is home to 28 different species of snakes.  Only 4 of them are venomous and they are all in the Pit Viper family and are rare.  The most widespread of the venomous snakes is the Timber Rattlesnake which is found in Allamakee County and most of Eastern Iowa where suitable habitat is found.  Along the Missouri River in Plymouth County is the Prairie Rattlesnake, in Bremer County and near Muscatine are small populations of Massasauga Rattlesnakes and in extreme Southeast Iowa along the Missouri river are copperheads.  Iowa does not have cottonmouth or water moccasin snakes even though the northern water snake, a nonvenomous species is often mistaken for them.”

“In the Driftless Area, 1 or 2 people are bitten each year by timber rattlesnakes.  The last known fatality from a venomous snake in Iowa was over 100 years ago.  Nationwide there are around 8,000 bites from venomous snakes yearly with less than 10 being fatal each year.”

“By nature, Timber rattlesnakes are very docile.  It takes them 28 days to rebuild their venom supply and they do not want to use it on something they cannot eat.  A snake can eat something 3 times the width of their neck, which is about as big around as an adult male’s thumb. Venom begins the digestion process for rattlesnakes and with our cold winters in Iowa, they cannot afford to waste venom on things that they will not be able to eat.  A timber rattlesnake can strike about half of their body distance.  If one is encountered in the wild, keep your distance.  They will not chase you.   August and September are the breeding season for timber rattlesnakes and the snakes will become more active.  This summer with the dry conditions the snakes are stressed and are moving out of the steep rocky south-facing bluffs where they typically reside and moving closer to water.    Timber rattlesnakes are protected in Allamakee County and it is illegal to kill them unless within 150 feet of an occupied building.”

Callie Thorson, RN, ER Supervisor at Veterans Memorial Hospital adds, “We are extremely excited to have the antivenom available here at VMH in our emergency department. This is just one more great option that allows for us to treat our patients and get them the medication that they so desperately need in a snake bite situation.”