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.
In today’s fast-paced world, cellular phones have become a primary means of communication. The technology has advanced rapidly and now people carry sleek smartphones full of apps you did not even know you needed. Cell phones operate off of cellular towers, with your cell phone bouncing its signal to the closest tower, which then relays that signal onward. As you travel farther from urban areas or travel into terrain that is hilly or mountainous, that cellular signal disappears as you are able to connect with fewer and fewer towers. How do you communicate when you are in an area with no cellular towers or where the terrain inhibits your connection to these towers? Satellite phones.
Satellite phones, or sat phones, are mobile two-way communication devices that use satellites orbiting the Earth to receive and transmit data. Sat phones rely on line-of-sight with their satellites to establish a connection. Since they rely on line-of-sight, they work best in open areas with a clear view of the sky. Using them indoors, in vehicles, and even in a city surrounded by tall building and wires will hinder your signal. Satellite constellations are either configured as geosynchronous or low Earth orbit.
Geosynchronous satellites, also called high earth orbit or GEO, are very large satellites that maintain a high altitude (around 22,000 miles) orbit and follow the Earth as it spins. This means that they are always centered along the Equator and generally remain in a constant location in the sky. A constellation of perhaps four satellites will be able to provide coverage for nearly the whole globe. Because of their size, these satellites are able to handle large volumes of data. However, because of their height, they have significant delays in transmission, resulting in momentary pauses for the person on the other end of the line. Since sat phones rely on line-of-sight, polar coverage is hindered and it may be difficult or impossible to get a signal if you are in a canyon or a mountainous area.
Low Earth orbit, or LEO, satellites offer a significantly lower orbit, around 900 miles. They are much smaller and lighter when compared to their GEO counterparts, and there are more of them in orbit. A typical LEO constellation consists of up to 60 satellites orbiting the earth at high speeds. This means that at any one time you will have line-of-sight to at least two or three satellites, giving you more reliable coverage if you are in a polar or mountainous region. Since LEO satellites are much smaller, they are more suited to voice transmission or short text/SMS messaging.
These days almost anyone can benefit from owning a sat phone. Are you a mountain climber or trekker who routinely travels far up in the mountains in small groups? Do you fish in exotic locales, isolated beaches, far down rivers that time forgot, or clear high-mountain lakes? Does the thrill of an African safari stir something deep and primal within you? Even for those who do not typically travel abroad, our own backyards are ripe with places where there is little to no cellular coverage. Anyone who likes to be prepared should know that cellular networks will be the first to crash and/or become overloaded in an emergency or disaster situation while satellite networks will be much more reliable. No matter your pleasure or purpose, satellite phones are a reliable communication alternative.
You can expect to spend in the range of $500-$1500 on a sat phone, depending on your particular needs. Pricing structure for airtime varies with each manufacturer, but a safe estimate is around $2 per minute, plus a monthly service fee. This is significantly lower than roaming charges offered through some cellular networks. Many vendors also rent sat phones for about $75 per week plus airtime.
It is worth noting that, since Global Rescue requires two-way communication with our members, a sat phone is just one method of enabling this.
Satellite phone use is restricted, and in some cases illegal, in a number of countries. Examples include: North Korea, India, Myanmar, Cuba, Iran, Libya, Sudan, Poland, Hungary, and Angola. Please confirm coverage details with your provider prior to purchasing or renting a phone and research possible restrictions imposed by the countries you’ll be visiting.
Should you have questions or wish for further information on sat phones, please post a comment below or feel free to contact Global Rescue at 617-459-4200.
It is impossible to know exactly when or where an injury will occur. While hunting deep within the triple canopy forests of Cameroon, a Global Rescue member thought he had seen it all. Despite having been charged by a buffalo and challenged by a gorilla in the preceding days, the member was unharmed and determined to continue on with the hunt. He understood the inherent dangers of hunting in Africa and felt that he had taken the necessary precautions to deal with the native animals and insects. What he had not envisioned, though, was that the most terrifying moment of the trip would come from an object as seemingly harmless as an elastic band.
Several days into his trip, the member was struck in the eye by an elastic band that had broken under tension. Immediate pain and a flash of bright light were followed by the loss of vision in the member’s eye. Over the next few hours, his vision slowly began to return but it remained blurry. Soon after the initial injury, the member contacted Global Rescue.
Immediately upon receiving the call, Global Rescue critical-care paramedics began to gather more information from the patient. Utilizing improvised items, including the Global Rescue Membership card, as a basic reading chart, the patient was asked to read the phone number from his outstretched arm. Unable to complete the tests, the patient acknowledged sensitivity to light, and noticed that his injured right eye felt a bit firmer to the touch than his left. Having consulted ophthalmologists at Johns Hopkins and given the risk for a permanent loss of vision in the eye, Global Rescue began making plans to evacuate the member.
Deep within the forest, the hunting party began their four hour journey to the nearest airstrip. Global Rescue then secured rights to the only air provider permitted to land on the unlit grass runway. While our operations team was confirming with the patient that a plane would arrive at first light to take him out of the forest to Douala, they were also busy arranging and coordinating transportation to a hospital with a world class ophthalmology department in Belgium. Upon arrival in Douala, he boarded a flight to Belgium, where the staff at the hospital was awaiting his arrival.
The patient was soon examined by the ophthalmologist, who examined the injured eye and provided the required treatment. After consulting with the doctors at Global Rescue, the member was deemed sufficiently stable to return home for continued care in the United States.
While hunting in a remote part of Canada, one Global Rescue member never imagined that fog would be his biggest obstacle since facing a quintuple-bypass in 2004. Global Rescue received a worried call from the member’s wife stating that persistent fog was creating dangerous flying conditions and delaying his scheduled helicopter flight home. For most, this postponement would mean hunting for a few more days, but for this Global Rescue member, who had already run out of his heart medications, it had become a life threatening situation.
Global Rescue immediately assessed the situation and began coordinating with helicopter assets, the member’s Primary Care Physician, pharmacies and the outfitter. Having consulted with Johns Hopkins doctors, Global Rescue’s in-house medical team provided the member with advice to help keep his heart condition under control while he was waiting without medication. As soon as there was a window of time without fog, a helicopter was dispatched to the hunter’s location. The member along with six others in his party were extracted and transported to base camp. The helicopter pilot greeted the member with a package containing all of his medications and a potentially grave situation was averted.
After the member was safely home, he wrote to thank Global Rescue:
“Please convey my deep thanks to all who participated in this effort to help me during this episode. I and the others in my hunting party were very impressed with the thoroughness of your efforts, your commitment and, perhaps most important personally, the support and comfort that you gave to my family. I will remain a Global Rescue client and will laud your capabilities and performance at every opportunity. Thanks again.”
Denis Karnosky, October 2012