Monthly Archives: November 2016

No really, snakes can hurt you after they’re dead

Even though we have all (hopefully) been taught that dead snakes can still envenomate people, apparently it hasn’t been reported much in the literature. I say this because this case report is in press as of 18 Nov 2016.
Southern Copperhead
In this instance a young man killed a copperhead by cutting it into three pieces. While holding the piece containing the snake’s head, “his right index finger brushed against the fang and was inadvertently punctured.” I’m sure all of us think that is exactly how this happened. Pain and swelling followed, so the patient went to his local hospital where he received 4 vials of antivenom.
There was further progression of the swelling and ecchymosis, so another 4 vials were administered. The patient was then transferred to a tertiary center “with concern for compartment syndrome of his hand.” Another 2 vials were given and the hand was elevated, and no operative intervention was done. Of note, his labs showed he did not have a bleeding diathesis, but readers of this blog already knew that.
I wish I didn’t have to say it, but sadly some people out there still believe that fasciotomies are required after snake bites. Truthfully, based on the evidence, the best treatment is antivenom and elevation, not surgeries that can cause complications and haven’t been shown to give benefit.
This paper does note that there have been multiple case reports of envenomations by dead rattlesnakes or rattlesnake heads. One even had been freeze-dried, bought at a gift shop, and used as a tie tack. Almost all of those required antivenom. This is an interesting thought, as recently deceased snakes likely retain the ability for the venom gland to contract reflexively. Envenomation from a freeze-dried snake has to be retained protein on the fang itself, as the ducts aren’t functioning anymore. This particular episode is the first documented case involving a copperhead that required antivenom.
So it is more than just an old wives tale. Dead snakes can still evenomate you, even if they’ve been dead for quite a while. So stay away from the pointy ends of snakes, and stop killing them for crying out loud.

Clinically Significant Envenomation From Postmortem Copperhead (Agkistrodon contortrix)
http://www.wemjournal.org/article/S1080-6032(16)30225-3/abstract