Dr. Jon Femling, M.D, Ph.D. and clinical vice chair of emergency medicine at UNM Hospital, breaks down the fear factor by advising on how to avoid rattlesnakes, what to do if bitten and what to expect.
Susan Morée:
A person is out hiking, they're walking along in the forest, and suddenly they hear a rattlesnake. What should they do?
Dr. Jon Femling:
Stop immediately. I've been in this situation, I've been walking, and I hear the rattle. And I will tell you, it's not always immediately obvious where that snake is. I've had them be in front of me. I've had them be to the side of me. I've had them be under a rock to the side uphill of me as I was in the mountains. And so it's really important just to stop until you've figured out where that rattle is coming from so that you can avoid where that snake is as much as possible.
Susan Morée:
I understand that rattlesnakes don't really want to bite us if they can avoid it. Can you talk about what a person can do if they feel a little trapped by the snake or feel a little paralyzed with fear?
Dr. Jon Femling:
Absolutely. The snake wants nothing to do with us. And, you know, there's sort of, I will say, a fable that the snake sort of made a deal with us. It rattles to let us know it's there, and our side of the bargain is to leave it alone. And I think that's a great example of just the best way to interact with snakes, especially the rattlesnake. It doesn't want to do it. It doesn't want to deal with us. It doesn't want to waste its time with us. It doesn't want to eat us. And so its rattle is a way of saying, 'Hey, I'm here. Please leave me alone.' And it's good just to stop and take a look. And what I see people do, and I see pictures of this all the time, is they pick up rocks and they start throwing it at the snake. And most of the time, that just makes the snake go on defense, coil up, and now be ready to strike out. Where if you just take a deep breath, see where it's at, and then find a way to go around the snake that gives them space, everybody leaves that experience happy, and no one has to be bit and has to come into the emergency department.
Susan Morée:
And let's say the worst does happen and a person gets bitten by a rattlesnake. What do you recommend that they do, especially if they're kind of out in the middle of nowhere?
Dr. Jon Femling:
Absolutely. We worry about this quite a bit. The best thing to do, and again, from an emergency medicine standpoint, you pretty much can tell me almost any emergency and I'll say, 'Stay calm. Take a few deep breaths, we can get through this.' And the same is true with rattlesnake bites. What you want to do is not to sort of freak out and start running around and cause other damages and trip over things and fall into cactuses. Just stop for a second, take a deep breath, and then make your way to safety as best as you can. You don't have to do anything fancy. You don't need to put on a tourniquet. You don't need to hold it above your head or hold it in some fancy way. Just remain calm and get out as quickly as you can. From our standpoint, you know, I've seen a number of bites over the years, and you've got time. You know, you don't have days. You've got hours, and you do want to get to safety as quickly as you can, but it's not like you're going to die within the next few minutes. And I think that's really important for people to understand is that they have time to safely get to the emergency department. And in the state of New Mexico, you can go to pretty much any emergency department, get that first dose of antivenom. And then you can be brought up to Albuquerque to be monitored and then get repeat doses as needed. I've seen that pattern happen many times over the years. You have a little bit of time, not a lot of time, but no reason to panic. Get to the emergency department safely and we're happy to take care of you.
Susan Morée:
And what happens to a person's body once the venom enters into it? Does it cause damage?
Dr. Jon Femling:
Yeah, so what I typically have seen is with some bites you see alterations in the coagulation factors, and that's one of the tests that we do early on to see whether or not people are affected. But then what I've also seen, which is much more sort of dramatic, is the affected area begins to swell. There's some discoloration. It can be quite painful. And sometimes you'll see that start to progress. Sometimes pretty quickly once it starts going. I've actually watched it sort of move, you know, a couple of inches, even after we've given that first dose until it slows down and stops. That's why it's important not to spend a long time getting to me, but you do have some time before it starts to kick in. I've seen pretty impressive swelling and discoloration of limbs from that, and if it's not stopped, it could become lethal, and it's important to come and get care.
Susan Morée:
Okay. Well, thank you so much, Doctor. I really appreciate your taking the time to talk to us.
Dr. Jon Femling:
Absolutely. Happy to help anytime I can.
