While enjoying a family vacation on a beach in southwestern France, Carolyn Lanzetta experienced a parent’s worst nightmare. Suddenly her three-year-old daughter, Cate, had a full-blown seizure. The toddler fell down, started convulsing and vomiting, and became unconscious for several minutes.
Cate was rushed to the local hospital. Her bloodwork and a CT scan came back normal, but doctors recommended that Cate undergo additional testing before the Lanzettas took the long flight home to New York City.
“Obviously, I was very nervous,” said Carolyn. “In the middle of the night, everything rushed through my mind: How were we going to get her home? Should we fly to Nice to get these tests done? Should we just go back to Paris and find a way to do it, or go to the closest hospital?”
The next morning, Cate had more seizures. The Lanzettas immediately took her to the children’s hospital in Bordeaux, where she was admitted.
Carolyn contacted Global Rescue. “I said, ‘I don’t know what to do. I don’t know what’s happening but I might need your help to get my daughter home if this gets worse.’”
The Global Rescue Operations team immediately began monitoring Cate’s treatment, conferring with the hospital’s doctors about appropriate tests and arranging for Cate’s records to be sent to Global Rescue.
“The Global Rescue Operations team was in touch with us on a constant basis. It was a huge feeling of relief that we weren’t alone, that the Global Rescue team was making sure that Cate was being treated at the level we would want her to be treated, that she was getting the right tests, and that the medicine was the correct course of action.”
Soon after, Cate was diagnosed with a severe, rare form of epilepsy. “Immediately our priority was how to get our daughter home,” said Carolyn.
Global Rescue deployed one of its critical care paramedics to fly to Bordeaux to meet the Lanzettas, care for Cate, and provide medical support on the journey home. The company handled all of the travel arrangements for the family.
Arriving at the hospital, Global Rescue’s paramedic met with the neurologist to review the medications and confirm checkout information. The next morning prior to the flight, he met the family for breakfast, during which Cate had several seizures. “He was able to see the seizures and was taking notes constantly on everything,” said Carolyn.
Then the journey home began. “I was sitting next to Cate, and the Global Rescue paramedic was right behind us. Immediately after takeoff to New York, she started having seizures, one after another. I was having an absolute heart attack. Here we were, stuck on this plane, and in an hour we were about to head over the ocean. Then there would be no turning back. It got to the point where I couldn’t sit next to her. It was really, really scary. I kept looking at our paramedic and he said, ‘It’s all right, she’s okay, she’s going to be fine.’ He was so calm, saying, ‘I have enough meds. We can get her back to New York. She could be having seizures the entire way and we’ve got enough medication to get her back.’”
Cate’s seizures finally subsided after 90 minutes and she was okay after the long flight.
“Had Global Rescue’s paramedic not been on that flight, I surely would have gone up to the flight attendants and told them that we had to get off the plane. There is no way I would have been able to get through that without Global Rescue’s medical help to say, ‘I can take care of it.’”
Carolyn continued: “It was a huge relief just to know that I didn’t have to be concerned about administering the medicine, administering it the correct way, making sure she was all right, if she ended up choking—all of those fears that go through you when your child is having a seizure.”
Landing in New York, Global Rescue’s paramedic accompanied the Lanzettas in the ambulance.
“When we arrived at the hospital, we learned that Global Rescue had provided the hospital with all of Cate’s medical forms and all the insurance information. We arrived and they greeted us with, ‘Hi Cate, how was your flight from Paris? Here is your bed.’ It was the most amazing feeling. We made it and somehow we are going to figure it out. Back in the U.S., they were able to treat Cate’s condition much, much faster than it would have been treated in France. The seizures would have just gotten worse and worse and worse, and more frequent as we had gone on.”
Carolyn praised the Global Rescue paramedic. “He was fabulous, just the nicest person to be traveling with and so engaging with the whole family, including my six-year-old daughter. He was so calming and gave us such a sense of confidence coming home. He followed up regularly to see how Cate was doing. It was so above and beyond what his duties were.”
Reflecting on the experience, Carolyn said, “If your child has a cold, you can figure it out and there are things you can do. But all of a sudden, something happens that’s new, that’s frightening. What do you do? Honestly I have not stopped talking about Global Rescue to everybody I know since we got back. Friends and family who travel with kids say, ‘How do we even travel without having Global Rescue?’”
Cate is doing very well with medication and a special diet. She has not had a seizure since leaving the hospital in New York.
“Having Global Rescue there was like having a big layer of comfort around you. It was just an entire other level of care and comfort that I could not have dreamed of. I knew that Global Rescue was looking out for us and taking care of anything we needed,” said Carolyn.
“There‘s no way we would have gotten through it without Global Rescue. I surely will not go anywhere out of this country without using Global Rescue. There’s just no way.”
The Lanzetta family
Every year, more women are making the decision to travel solo. In a poll of U.S. women by Booking.com, 72% responded that they are enthusiastic about solo travel and had traveled on their own for work or vacation. As the trend in solo travel by women continues, Global Rescue would like to share these tips:
1. Bring a communication device that works. In addition to bringing your cell phone (which you should make sure works wherever you’re headed), a satellite phone or messaging device can be extremely important in remote areas of the world where there are no cellular networks. They can also save your life in an emergency or disaster where cellular networks become overloaded or disabled.
2. Do your research. Read maps before venturing out to a new place and be conscious of areas to avoid. Get detailed information on your destinations and find out which neighborhoods have incidences of crime. Women should also be aware of major international hotels or key public locations along your itinerary where you can go if you feel unsafe.
3. Purchase medical and security evacuation coverage. If you need to get out of a tight situation, your insurance company isn’t going to do it. If you get hurt and need to be medically evacuated, or need to escape civil unrest, having coverage can save your life (and tens or even hundreds of thousands of dollars).
4. Alert friends and family to your itinerary. Do this before departing for your trip. Let people know when they should expect to hear from you next. Register with the U.S. State Department before your trip here: https://step.state.gov/step/.
5. Brush up on practical safety tips. Avoid telling strangers that you are traveling alone. Try not to establish patterns such as leaving or returning to your hotel at the same time every day. Maintain “situational awareness” and avoid walking alone at night. Do not stay on the first floor of a hotel or hostel. When using public transportation (train, bus, or ferry) in an underdeveloped country, if possible, ride in the highest class available. Other simple preparations include: carrying a whistle; carrying a small flashlight; carrying or wearing comfortable shoes; and carrying an ID, a small amount of cash, and a credit or ATM card on your person and not in your purse in case of theft.
As the world focuses on Ebola, cases of another serious disease are on the rise around the world. Dengue fever, which includes several variations including dengue hemorrhagic fever and dengue shock syndrome, has increased dramatically this year. In Malaysia, for example, dengue fever cases have seen a threefold increase compared to the same period in 2013, according to the country's health ministry. There have been more than 80,578 reported cases of dengue fever throughout the country as of 18 October.
Cases have grown especially fast in China as well. In the southern province of Guangdong, the number of reported cases jumped from 11,867 on 30 September to 21,527 cases on 6 October. As of 3 November, more than 43,000 cases have been reported.
With dengue fever also on the rise in the Americas, Mexico, and near the Texas border, it is imperative to be informed about the disease before traveling to any regions where you may be at risk.
Dr. Phil Seidenberg, Associate Medical Director with Global Rescue, shared some of the basic facts about dengue fever.
Like malaria, the disease is transmitted through the bite of a mosquito. However, there are several key differences between the two diseases.
“Dengue fever is a mosquito-transmitted illness, but it is viral, not parasitic. It is caused by a different mosquito than the type that causes malaria,” Seidenberg said. Dengue-carrying mosquitos are more likely to bite during the daytime instead of at dusk and dawn, as the malaria-carrying insects do, and are even found in urban areas. There are currently no medications that can be taken to prevent dengue fever, so mosquito prevention is critical.
If you have contracted dengue, the illness will surface in approximately 4-7 days from the initial mosquito bite.
Seidenberg outlined the most common symptoms, including:
· -- Muscle or joint pain
· -- Fever
· -- Headaches (particularly behind the eyes)
· -- Rash
Those who develop a more severe form of dengue fever may also experience:
· -- Bruising and bleeding (particularly at pressure points, such as around waistbands)
· -- Nosebleeds
· -- Gastrointestinal bleeding
“The more severe form of dengue fever is referred to as dengue hemorrhagic fever, which causes these symptoms,” Seidenberg explained. “With the more severe form, the platelet count drops, people bleed, liver enzymes go up, and people get a lot sicker.” Adults are more at risk for dengue hemorrhagic fever than children, who often get much less sick once they’ve contracted the disease. Those who have been exposed to or have contracted dengue previously are much more at risk for this form of the infection. Seidenberg points out that dengue hemorrhagic fever is not the same type as some of the African hemorrhagic fevers, such as Ebola.
Typical treatment for dengue fever includes treating the virus symptomatically, with hydration and Tylenol (not ibuprofen or aspirin) for normal cases. In the case of hemorrhagic dengue, patients should seek hospital care to be monitored and given fluids. Unfortunately, there is no way to treat the actual infection itself. Statistics vary, but approximately 80% of those infected experience fever and flu-like symptoms following an incubation period of 3 to 14 days. These symptoms eventually resolve provided the patient rests and gets plenty of fluids. The remaining 20% of patients can become severely ill, with symptoms including very high fevers, rashes, vomiting, intermittent consciousness and bleeding. According to the Centers for Disease Control and Prevention (CDC), dengue fatality rates range from 1%-10% depending on the individual and the timing and appropriateness of the treatment rendered.
If you’re traveling, check-in with Global Rescue, review updated dengue information in our GRID travel intelligence system, and consult the CDC website for locations with high rates of dengue here.
Global Rescue member Steven Huskey was on a hunting trip to the Canadian Rockies when suddenly things went very, very wrong.
“During a steep, snowy descent through the Canadian Rockies in pursuit of an elusive Big Horn sheep, I found myself sliding down the mountain toward a cliff. As I went over the edge, I instinctively grabbed for a sapling. It was like a made-for-TV-movie.”
With help from Global Rescue, Huskey lived to tell the tale of his ordeal.
“[As I fell,] the momentum of my weight and my pack dislocated my right shoulder, breaking the socket and tearing pretty much every tendon and ligament including my bicep. After finishing the descent with my arm duct-taped to my body and an extremely agonizing horseback ride to camp, I was able to call Global Rescue on the satellite phone,” said Huskey.
The Global Rescue operations team launched into action, making plans for a field rescue and evacuation to transport Huskey to a hospital to receive medical care. With significant snowfall forecast for the following two days, the helicopter rescue was set for the first break in the weather.
“First, they worked with my guide to ensure I was stable and gave him warning signs to monitor. Second and most impressive, they coordinated with my fiancée, the local medical personnel, the outfitter, the aircraft as well as the Royal Canadian Mounted Police and other local authorities,” said Huskey. “The snow and terrain prevented a ground rescue team from reaching my location, so as soon as the weather broke, Global Rescue had a helicopter en route. Their coordination and persistence was impressive.”
The helicopter transported Huskey to the hospital, where he was evaluated, admitted, and treated for his right shoulder dislocation. Global Rescue’s paramedics kept in contact with him throughout his ordeal to ensure he was receiving proper care until he was discharged.
Huskey’s advice: “If you are a back country adventurer, your Global Rescue membership should be at the very top of your packing list.”
According to the latest update by the World Health Organization (WHO) on 5 October, a total of 8,033 (probable, confirmed, and suspected) cases and 3,865 deaths from the Ebola virus have been documented in Guinea, Liberia, and Sierra Leone. Some cases have also been reported in Nigeria and Senegal.
Late September yielded the first case imported to a non-African country, after a Liberian national traveled to Dallas, Texas. He succumbed to the virus on 8 October in Dallas. Most recently, a healthcare worker in Madrid, Spain, contracted the illness while caring for an infected patient transported to Spain for treatment. Both the U.S. and Spain cases did engage in contact with the public while symptomatic, and intense contact-tracing efforts were enacted by both nations.
In recent months, authorities in multiple nations have introduced a wide range of preventative measures in response to the deteriorating Ebola outbreak, including border closures, flight bans, and stricter screenings at country gateways. Individual airlines have also implemented their own restrictions.
U.S. authorities announced on 8 October that travelers from Guinea, Liberia, Nigeria, and Sierra Leone will undergo mandatory screenings for the Ebola virus at certain domestic airports. The measures will include questionnaires as well as temperature scans. The checks will be implemented at New York City’s John F. Kennedy International Airport (JFK), Washington D.C.’s Dulles International Airport (IAD), Chicago’s O’Hare International Airport (ORD), Atlanta’s Hartsfield-Jackson International Airport (ATL), and New Jersey’s Newark Liberty International Airport (EWR).
Global Rescue has air assets in Africa to perform air ambulance evacuations. Response time depends upon many factors, including weather, local asset availability, location, and local laws. However, we can and will assist in supporting our members with any and all services that are medically appropriate, and which fall within the guidelines of the incident and destination countries regarding quarantine and infectious disease transportation. Global Rescue will provide these services within the capabilities of our air providers, and the medical resources available locally, regionally, and at the member’s destination. For members with Ebola or suspected Ebola, Global Rescue will transport pursuant to all required quarantine and infection control procedures and restrictions, which may delay or prevent transport.
Nico Monforte, 2014 Junior Worlds Skicross team member
In April 2014, Nico Monforte was warming up for the freestyle Junior World Championships with the U.S. Ski Team in Valmalenco, Italy. After a fall, Nico hurt his shoulder and suffered severe fractures to his left tibia and fibula. Nico wrote to thank Global Rescue for assistance during his ordeal:
“While I was in the hospital in Sondrio, Italy, the U.S. Ski Team doctors called Global Rescue to assist in locating a better facility for surgery and care. Global Rescue aided in my transfer to a hospital in St. Moritz, Switzerland, and oversaw the rest of my medical needs and travel home.
“Since the first call was placed in Italy to Global Rescue, there were nothing but positive and helpful interactions. The Global Rescue critical care specialists were always informed and up-to-date concerning my situation, putting my medical needs at the forefront of every call. When my mom, Johanna Monforte, placed a call from back in California to try to coordinate a trip to see me in the hospital, she was immediately linked with the Global Rescue specialist who was working on my case. The specialist updated my mom and made her feel comfortable with the situation. Throughout the whole experience, the Global Rescue team made me feel that I was where I needed to be, and that everything was being done to the highest of standards to ensure a full recovery.
“I am very happy with the whole experience dealing with Global Rescue. The services provided by Global Rescue helped me get to a facility that could cope with the severity of my injuries. Currently my health is good. My recovery is on track and the doctors are happy with my progress. I am a long way from 100 percent, but am progressing every day and headed in the right direction. We are shooting for a return to snow in December and I’m hoping to return to competition late next season.
“I would highly recommend Global Rescue to any of my friends and family, or to anyone who is traveling. The services I received from Global Rescue helped get me the care I needed to make a full recovery. I am proud to be a member of the U.S. Skicross team and couldn't be happier with the Global Rescue partnership with the United States Ski Association.
"Thanks again for all your help!”
John Bates during a fishing trip to New Zealand
Kiritimati, also known as Christmas Island, is one of the most remote places on earth, lying in the middle of the Pacific Ocean. With many distinctive species of fish in the surrounding oceans, Christmas Island attracts anglers from all over the world.
Global Rescue member John Bates of Billings, Montana, traveled to Kiritimati on a much-anticipated fishing trip over the summer. Late one evening, he fell seriously ill at his lodge. His symptoms included weakness, high fever, an inability to walk, and difficulty breathing.
Dr. Gordon Cox, a retired pathologist traveling with Mr. Bates, contacted Global Rescue for help when Mr. Bates was unable to do so. Because of its remote location, Kiritimati presents challenging communication issues. Communication on the island is very poor, with the only access provided via the island’s “communications center,” and even then in limited fashion.
The Global Rescue medical team determined that Mr. Bates’ complex medical history meant that he was particularly sensitive to the symptoms he was experiencing, with a life-threatening risk of sepsis, in a remote location where proper care was unavailable. It was clear that Mr. Bates’ condition necessitated evacuation from the island to receive needed care.
With no time to waste in obtaining the best care for Mr. Bates, Global Rescue physicians recommended an immediate medical evacuation from Christmas Island to a hospital in Honolulu, Hawaii, for medical treatment. It was determined that this was the closest, best hospital for treatment under the circumstances.
Following a brief hospitalization where he received stabilizing care, Mr. Bates was able to travel home to Montana. He made it home safe and sound, praising the efficiency of the medevac team and thanking Global Rescue for its role in his medical care.
Mr. Bates had the following to say about his ordeal:
“First, I would suggest to the tour company I was traveling with, which books trips to Christmas Island, that they mandate that anyone going to fish in a remote area like Christmas Island sign up with Global Rescue. You’re nuts if you go someplace like Christmas Island and don’t have Global Rescue in your back pocket.”
“Second, I’d suggest that someone in your group investigate the communications technology available at any destination. When in doubt, have a satellite phone, acquired specifically for the purpose of the trip, to provide a clear line of communication in case of emergency.”
“It was Dr. Cox, in fact, who had suggested Global Rescue to me. I looked at the information and thought maybe I should join up. I’m very grateful that I did. I’m here, and I’ve got all of my limbs. I’m glad I had you guys. Having seen what you can do, I’m a believer.”
“Global Rescue’s follow-up system certainly makes you feel you’re being tended to. It becomes apparent that they’re on top of things, and that’s important.”
Dr. Gordon Cox (L) with John Bates (R)
As the Ebola outbreak continues, here is an update on this rapidly changing situation as well as advice for Global Rescue members regarding travel:
The current outbreak of Ebola virus disease (EVD) in West Africa began in Guinea in December of 2013; however it was not identified as Ebola until March 2014. This delay likely allowed the virus to gain significant traction within the locales where EVD is now present. By May, EVD spread to Liberia and Sierra Leone, likely aided by very porous regional borders. EVD was imported to Nigeria by a single sick traveler in July from Guinea, which is not geographically contiguous with any of the original affected countries. Senegal also reported an imported case in late August. A Senegalese student who had been studying in Guinea was infected, developed symptoms and returned home to Senegal. There have been no confirmed cases of EVD importation elsewhere in the continent, or world, since the Senegal case.
As of the most recent World Health Organization (WHO) Situation Report dated 18 September, the current total number of cases associated with the West Africa outbreak is 5,335. This figure includes 2,622 fatalities as of 14 September. Currently, the only countries affected by the West Africa outbreak are Guinea, Liberia, Sierra Leone, Nigeria, and Senegal. Widespread transmission exists in Guinea (942 total cases), Liberia (2,710 total cases), and Sierra Leone (1,673 total cases). In Sierra Leone, dozens of new Ebola cases and deaths were recorded as the country concluded its three-day nationwide lockdown on 21 September. Nigeria, and Senegal have fewer than 25 total combined cases, and thus far have not seen the intense transmission noted in other affected countries. This is likely due to aggressive isolation efforts within both countries once import-vectors were identified, as well as public-health campaigns and response posturing by international healthcare organizations.
Unrelated Outbreak – Democratic Republic of Congo
There is an additional outbreak of EVD in Equateur province in the Democratic Republic of Congo. While the strain identified in the DRC is the same as the strain affecting West Africa, it has been confirmed to be epidemiologically unrelated. The DRC outbreak is believed to have started in the village of Ikanmongo, where a pregnant woman died on 11 August. She was reported to have recently butchered a bush animal, and then fell ill with flu-like symptoms. As of 17 September, there have been 71 cases reported, and 40 fatalities.
The outbreak zone within the DRC is remote – approximately 1,200 kilometers from Kinshasa. There are no major transportation routes that connect the zone with other regions of the DRC, and risk of transmission/importation to other major population centers is considered unlikely. U.N. analysis suggests that the outbreak there is under control at this time
Prevention is primarily guided by awareness of how the disease is transmitted, and practicing safe hygiene. These preventative measures may include:
- Avoid nonessential travel to Liberia, Guinea, and Sierra Leone.
- If you must travel, please make sure to do the following:
- Practice safe hygiene. Avoid contact with blood and body fluids of people who are sick with Ebola. Regular hand-washing is essential and highly recommended.
- Do not handle items that may have come in contact with an infected person’s blood or body fluids.
- Avoid funeral or burial rituals that require handling the body of someone who has died from Ebola.
- Avoid contact with wild animals and with raw or undercooked meat (bushmeat).
- Avoid hospitals where Ebola patients are being treated. Global Rescue can provide advice on facilities that are suitable for your needs.
Is it safe to travel during an outbreak?
While travelers should always be vigilant with regard to their health and those around them, the risk of infection for travelers is very low since person-to-person transmission results from direct contact with the body fluids or secretions of an infected patient.
Is it safe to travel to West Africa?
The risk of travelers becoming infected with Ebola virus during a visit to the affected areas and developing disease after returning is extremely low, even if the visit included travel to the local areas from which primary cases have been reported. Transmission requires direct contact with blood, secretions, organs or other body fluids of infected living or dead persons or animals, all of which are unlikely exposures for the average traveler. That being said, the Centers for Disease Control and Prevention (CDC) has issued Level 3 (Avoid Nonessential Travel) notices for Liberia, Guinea, and Sierra Leone. Should travel to one of these locations be necessary, be mindful of the prevention guidance noted above.
Water-based activities provide endless opportunities to have fun in a safe, enjoyable, and healthy manner. However, the danger of drowning or near drowning is never far away. While enjoying the aquatic environment, it is important to educate ourselves and others about potential risks, as well as to maintain awareness of our surroundings; education and vigilance can change a potential tragedy into a mere “scary event.”
Take a moment to view the video above, an actual rescue of a drowning child. Can you spot the child in trouble before the lifeguard does? This video is a great reminder that drowning doesn’t look like drowning. Notice how many people are within 15 feet of the victim. None of these people had a clue that the child was at risk of drowning.
Most people get their mental image of drowning from the movies: a victim who thrashes about, screaming for help and waving frantically at bystanders. A distressed swimmer may do this briefly prior to actually beginning the drowning process (it is known as “aquatic distress”); however, once the swimmer enters the Instinctive Drowning Response, it may be very difficult to tell that he or she is in trouble.
Keep the following facts in mind to better identify swimmers in trouble (Source: The Journal of the U.S. Coast Guard Search and Rescue):
· Except in rare circumstances, drowning people are physiologically unable to call out for help. The respiratory system was designed for breathing. Speech is the secondary or overlaid function. Breathing must be fulfilled before speech occurs.
· The mouths of drowning people alternately sink below and reappear above the surface of the water. The mouths of drowning people are not above the surface of the water long enough for them to exhale, inhale, and call out for help. When their mouths are above the surface, they exhale and inhale quickly as their mouths start to sink below the surface of the water.
· Drowning people cannot wave for help. Nature instinctively forces them to extend their arms laterally and press down on the water’s surface. Pressing down on the surface of the water permits drowning people to leverage their bodies so they can lift their mouths out of the water to breathe.
· Throughout the Instinctive Drowning Response, drowning people cannot voluntarily control their arm movements. Physiologically, drowning people who are struggling on the surface of the water cannot stop drowning and perform voluntary movements such as waving for help, moving toward a rescuer, or reaching out for a piece of rescue equipment.
· From beginning to end of the Instinctive Drowning Response, people’s bodies remain upright in the water, with no evidence of a supporting kick. Unless rescued by a trained lifeguard, these drowning people can only struggle on the surface of the water from 20 to 60 seconds before submersion occurs.
Look for these signs of drowning when people are in the water:
· --Head low in the water, mouth at water level
· --Head tilted back with mouth open
· --Eyes glassy and empty, unable to focus
· -- Eyes closed
· --Hair over forehead or eyes
· --Not using legs—vertical
· --Hyperventilating or gasping
· --Trying to swim in a particular direction but not making headway
· --Trying to roll over on the back
· --Appear to be climbing an invisible ladder
We encourage everyone to adhere to basic safety practices while on the water. Wear life vests if you are in a boat, even if it is hot. If you don’t like the clunky vests because they are uncomfortable, spring for a paddle sports vest. They are much more comfortable, and can be worn all day without a problem. If you see someone drowning, call for help or alert the lifeguard. Remember: Reach, Throw, Row, Don’t Go!
1. Reach – Reach out to the victim with an arm while holding on to the dock, boat. Reach out with a pole, stick, float, etc.
2. Throw – If you can’t reach them, throw a life ring/ throw rope/ life jacket, etc. to the victim.
3. Row – If you have a watercraft and are proficient enough to use it, use that to reach the victim. Mind the propellers.
4. Don’t Go – Unless you are trained in water rescue, do not swim out to rescue the victim. Even a small child can easily drown an adult if the adult is not trained. Call for help and look for other options. (It may be naïve to believe that this warning will keep a parent from attempting to rescue their child. So, if you must go, go with support. Find a float, life ring, etc., and use that for support. Be careful.)
Snakes are an integral part to many ecosystems and, as an outdoor enthusiast, it is only a matter of time before you encounter one in the backcountry. Venomous snakes are most prevalent in temperate and tropical climates, with April-October being peak snakebite season. There are roughly 15-20 deaths per year in North America related to venomous snakes. The risk of dying from a venomous bite increases when multiple bites are involved and when the bite occurs in the very young, old, or in persons with underlying respiratory or cardiovascular problems. In the US, venomous snakes account for only about 20% of all snakebites and out of that 20%, many do not result in envenomation. Some studies suggest that up to 20% of rattlesnake bites are deemed ‘dry’ bites, with no venom being injected. Dry biting is a sign of maturity in the snake; more experienced snakes will use a dry bite as they try to gauge the level of a perceived threat and since snakes do not have an infinite amount of venom they will try to use it sparingly.
The majority of poisonous snakes in the US are pit vipers. Rattlesnakes, copperheads, and cottonmouth (water moccasins) snakes are in this family, known as Crotalidae. Typically, pit viper victims tend to be young males, 11-19 years old, who are bitten on the hand while trying to pick up the snake. Alcohol has been shown to be a common factor in these incidents.
The best guideline for snakes is complete avoidance. The old adage that ‘it’s more afraid of you than you are of it’ is generally true, and most snakes only bite when they feel threatened. If snakes are encountered, give them a wide berth and continue on your trek.
As there are many types of snakes, venomous vs. nonvenomous, and different types of venom, hemotoxic vs. neurotoxic, opinions on treatment methodologies can be as numerous as the different snakes themselves. However, many experts tend to agree that certain folklore treatments should be avoided. These include pouring alcohol over the bite, making an incision over the bite site, cauterization, amputation, use of electric shocks, and packing the extremity in ice. Many of these so-called treatments are urban legends. The use of suction (attempting to ‘suck’ the venom out of the bite) is controversial but all experts agree that if attempting this technique you should not use your mouth to apply suction.
Field management for snakebites should focus on limiting the systemic spread of the venom and rapid evacuation of the victim to a hospital equipped to handle envenomations. During the evacuation, you should do the following:
1. Keep the patient calm and inactive. Remove jewelry and constrictive clothing.
2. Clean around the bite site and keep the wound free from dirt and debris by covering with a sterile dressing.
3. Immobilize the limb in a neutral position.
4. Avoid the use of compression bandages unless bite is from a neurotoxic snake (coral snake, cobra, krait, or other).
For those with advanced medical training, continue to monitor vital signs, ensure airway is patent, be prepared to treat victim for anaphylaxis, nausea/vomiting, and pain. The patient should be continuously monitored for the first 4-6 hours. If after 6 hours the victim does not display any adverse signs or symptoms, it is generally safe to suspect a bite without envenomation. Support hydration orally if possible, start an IV in an unaffected limb if available. Defer food ingestion during prompt evacuations; if a prolonged evacuation is presented, nourishment will become important to support strength and health. Avoid alcohol intake. Evaluate victim’s tetanus status and consider giving tetanus toxoid. Antivenin is the only proven therapy for snakebite but only when it is specific for the snake involved. DO NOT try to kill or capture the snake for identification purposes. Dead snakes, even several hours later, can reflexively bite injecting venom causing either a second bite or biting another member of the group. Embrace technology and snap a photo with your smartphone…using the zoom!
Wherever your travel takes you, Global Rescue encourages you to do a thorough area study of your destination and research the native flora and fauna that might be harmful.
Read here about a medical evacuation we conducted for a member bitten by an African cobra in Namibia.