The article by Josh Mitchell, staff reporter, began, "A
Virginia man training for a run was bitten on his left foot by a rattlesnake in
Tongue River Canyon near Dayton on Monday afternoon, according to Dayton Rescue.
Dayton Volunteer Firefighter/EMT Levi Dominguez said the man was in 'stable'
condition when he was transported to Sheridan Memorial Hospital. Dominguez said
the man, whose name and age are not being released by rescue officials because
of medical privacy rights, was hiking with his wife when the snake bit him."
(There was more, but you get the idea.)
Hiking?!!! Ouch. That's gotta hurt as much as the snake
bite!! We were definitely running.
Having grown up in Small-Town America, I know how fast news
travels. It was still quite a surprise when one of our new Dayton friends, Pat
Shilling, who's running in the Bighorn 30K race, told us we made the front page of
the Sheridan newspaper. From my years working with the justice system, I
should have known newspapers have staff checking on every lead they can get from
public safety departments, the courts, other pubic offices, ambulance crews, hospitals, etc. for stories.
It's a wonder we haven't heard from an ambulance-chaser
yet. Let's sue that snake!!
"IT BIT ME!"
Two miles from the end of our run yesterday afternoon Jim gave me more fodder to
write about so no one would get bored reading our journal. He doesn't know if he
stepped on - or just too closely to - a big 'ole prairie rattlesnake, but he's positive he
And he's got two puncture wounds in the front of his ankle to
Now that's a first for either of us. We've each seen plenty
of rattlers in our years living in Montana and running all over the country. There
were some rattlesnakes living in the field behind our Billings house,
and we've seen some on trail runs in sunny, exposed, rocky areas in other
states. I was very alert last summer running/hiking the rock-filled
sections of the Appalachian Trail, especially through Pennsylvania because
timber rattlesnakes are
common there. I came very close to one rattler that I could hear right next to
the trail (there's a
in our AT journal).
This time I also came pretty close to the one that bit Jim. He
was only six or eight feet ahead of me on the trail, close enough for
conversation, when I simultaneously heard him yelp and looked up to see a snake
wiggling between his feet.
Jim immediately reported that he'd
been bitten. My intelligent response: "Are you kidding??"
No, he was dead serious.
This is the perpetrator after (s)he slithered off into the
foliage beside the trail:
I estimate the snake was about 36 inches long. When we enlarged the original,
high-resolution photo on our computer, we counted at least twelve rattles. A
friend counted thirteen in the blow-up. Part of the tail is obscured by foliage
and the tip is under the snake's body, so we aren't sure of the exact count.
The photo gets fuzzy and pixel-y this close up.
The ironic thing is that we were
talking about emergency supplies we should maybe carry during the Bighorn
100-miler. I realized Saturday morning just before we began running with Dave
Westlake at Dry Fork that my Camelbak bladder was leaking from a puncture and I
had to make due with a spare UD bottle and fresh water from springs along the
route. I suggested to Jim that maybe during the race, especially at night during
the long, desolate upper portions of the course, I should carry an extra,
empty bladder in my pack in case there was another problem.
Jim's response was that we can't carry everything for every
contingency or we'd be too weighed down with extra supplies. The last thing I said
before he tangled with Mr. Rattler was, "It'll be my luck to be out there
without a spare bladder and something will happen to the one I'm using - like
that second camper tire that blew out when we no longer had a spare."
Now here we were in a hot, rocky canyon where we'd been
warned about rattlesnakes - in fact, we didn't take the dogs this time because of
Dave's warnings to us Saturday about snake sightings - and we weren't as
prepared as we should have been for a poisonous snake bite.
I'm not sure if a snake bite kit would have helped. You
can't just carry the anti-venom serum around with you, and that's the most
(only??) effective antidote to slow or stop the tissue necrosis caused by snake
venom. We knew the old remedy of making a slit and having a companion suck out
the venom was no longer considered effective (whew!). We knew we had to get
anti-venom from a rescue squad or hospital ASAP, but we didn't know what the
time frame for successful treatment is.
Jim recently got his EMT certification in Virginia, the poisonous snake bite "training"
was only about three minutes long. Apparently snake bites are pretty rare
in Virginia or that comes in an advanced training course.
The first thing we knew to do in our situation was stop running so the venom
didn't spread through his circulatory system as quickly. We were about two miles
from the trailhead at the end of a 12-mile training run through the Tongue River
Canyon (same place we ran with both dogs
Wednesday), up to Horse Creek Ridge, and back.
The snake bit Jim on the top/side of his left ankle. You
can see the two puncture wounds in this photo taken less than two hours later,
after his ankle had been cleaned:
The only symptom Jim noticed on the way out of the canyon
was pain radiating throughout his left leg. Neither of us knew what to expect. I
stayed behind him so I could watch him better. We didn't know if he'd be able to make it to the truck,
but we tried that first.
It would have taken much longer for me to run to the truck, drive into town for
rescue workers, have them go back out on the trail, and help him in. He was able
to walk the distance and, in hindsight, it was the best course of action.
When we reached the truck, Jim took off his shoe and sock,
and his ankle quickly swelled up. That was scary, too. It took us thirty minutes
to walk real fast to the truck, ten minutes to negotiate the dirt road back to
Dayton, and another five minutes before we rounded up several volunteer EMTs and
an ambulance. Our cell phones (Verizon) don't work in this area so we couldn't
call ahead. No one was
at the volunteer fire department. I ran next door to the Dayton town hall
and had a woman alert the rescue squad. Everyone was very helpful.
As an EMT, Jim has ridden in the back of an ambulance
several times now, attending to patients on their way to the hospital for
various emergencies. Being the patient was quite a different experience for him,
one that no role playing could accurately simulate! You can barely see Jim (in
the white hat) on the stretcher in this photo:
I followed the ambulance to the hospital in our truck, taking this picture
out the windshield:
While onboard, the EMTs checked Jim's "vitals" and started
an IV with a saline solution for the fluids he would receive in the hospital. Ambulances here do not
carry the anti-venom serum.
Jim was transferred to another ambulance with an Advanced
Life Support (ALS) team on board at the I-90 exit near Ranchester, five miles
away. The two men who attended to him are paid firemen/paramedics from the
Sheridan Fire-Rescue Department. They continued to monitor Jim's condition and notified Sheridan
Memorial Hospital they were bringing in a snake bite victim.
By now, an hour after being bitten, Jim's leg was
increasingly painful, his fingers and toes were tingling, and he had a metallic
taste in his mouth. He was also very thirsty, but that may have been dehydration
from our dry, sunny canyon run.
It took a total of thirty minutes to reach the hospital
after Jim got in the first ambulance, for a total of 1:15 hours elapsed
since the bite. We were pleased with the prompt, professional care Jim received
from the rescue personnel and hospital staff. I'm surprised how big the hospital
is, considering Sheridan has a population of only 16,000 people (only about
25,000 in the entire county - remember what I said about the sparse population
The emergency room was calm and mostly efficient. I'm glad
it wasn't hectic and the staff could give him the immediate attention he required. We came
in with dirty, sweaty bodies and clothes after running on dusty trails for four
hours. There was no time to stop at the camper, even though we drove right by
it. There was no time to clean up, change clothes, even get the dogs out of the
camper. Although it took a while to get him something to eat (about three hours)
and a shower (about five hours), the medical procedures were carried out
Here's Jim a few minutes after arriving in the ER:
Jan, the ER nurse (above) who attended to Jim from 4:30 PM
until her shift ended at 7 PM, and other staff members took down all the information about the snake
bite and Jim's medical history. The swollen area was very painful to the touch when
Jan cleaned the dirt off his foot and lower leg.
You can still see the dirt here:
The swelling continued to increase during the evening, but
had subsided some by the next morning. You can see the pen marks on Jim's lower
leg where the EMTs and nurse marked the progression of pain up his leg.
Dr. Robinson, the ER physician, examined and questioned
Jim further before ordering morphine for his pain, antibiotics to prevent an
infection, and anti-venom
serum to counteract the poison already coursing up his leg. Other
staff members came in and out, hooking up tubes. I was out of the room for a little while handling
insurance information so I missed some of the action.
Dr. Robinson helped calm our nerves when he said it is
important to begin the anti-venom treatment within four or five hours of being
bitten. The serum was flowing into Jim less than two hours after the bite. As
long as he wasn't allergic to it, there shouldn't be any lasting damage to his
body, the young doctor predicted.
The main problem with rattlesnake venom is tissue necrosis (death). The
doctor explained that snakes who feel threatened usually inject less venom into
humans than into an animal they want for dinner. They tend to conserve their
venom for what really counts - their next meal. That's good to know!
The venom apparently causes the mouse (or whatever) to bleed
internally and die. In humans, clotting is affected and tissues turn black and
die if treatment isn't given soon enough. Dead tissue doesn't grow back, so it's
a serious problem. Jim's blood was drawn soon after
arrival in ER and again the next morning to check for clotting and other things
that could be affected by either the venom or the serum. Everything
they tested for was OK. The fact that he's in great physical shape should help
Although snake bite procedures were new to Jim and me, we
figured it wouldn't be anything new to the hospital staff, what with all the
hot, rocky canyons, meadows, and range lands in the area that are favored by
rattlesnakes. Yes, it is the beginning of the season (June has been hotter than
normal, bringing out the snakes earlier this year), but surely snakebites are a
common emergency in the area?
We quickly learned there
was some research and other activity going on behind the scenes to properly
care for Jim.
This is NOT a common medical emergency for this hospital,
which surprised us. Staff members had to look up some of the information about
treatment. Jim said after I left for the night, several folks came in to see the
bite marks and talk to him because they hadn't seen a snake bite victim before.
And the staff and attending physician responsible for his care after he left the
ER (Susan Snyder, DO) gave conflicting information
about the efficacy of ice for the swelling.
We also discovered the hospital didn't have adequate
anti-venom serum for Jim and had to order more vials delivered ASAP via the
Sheriff's Department from the hospital in Buffalo, about 35 miles away. I saw
the deputy hand the box to a staff member out in the hall. (Too bad my camera
was out in the truck then!) The Sheridan hospital
usually gives patients between four and six vials of the serum for rattlesnake
bites, closely watching for allergic symptoms like nausea, fever, rash, or headache.
Fortunately, Jim developed none of those symptoms.
Hospital staff was also calling other hospitals around the
state to see if they had more serum in stock, in case Jim needed more than the
six vials now in hand. He used all six and didn't need more, but the pharmacist is ordering more
before 500 other runners arrive for the Bighorn races! Maybe our case is a
blessing in disguise for someone else who may be bitten this summer.
We soon learned another reason why the hospital doesn't keep much of the
stuff in stock - it's very expensive. We don't know just how much yet, but
apparently the six vials he received cost many thousands of dollars. Let's hope
his insurance covers most of it!
CANINE, EQUINE, BOVINE
When Jan found out we have dogs that run with us, she told
us that a canine vaccine is available for poisonous bites. Several staff members
said they've given it to their dogs to protect them. It's ironic they
aren't available for humans yet, but I presume drug companies are working on it.
I got a strange look on my face when Dr. Robinson told us
they'd have to use both equine and bovine serums to give Jim since Sheridan didn't
have enough of one for him. Was he getting serum intended for horses and cows??
I misunderstood completely. The serum is derived
from horses and cows, not given to them. We don't have enough internet
access to research how the stuff is made. (Maybe it's one of those things we
don't really want to know?) If someone has time to clue us in, we'd
appreciate the information.
Once Jim was stabilized and the morphine was
relieving his pain somewhat, hospital staff began talking with us more about the
races, which are a big deal in this small community. Dr. Robinson and an
orthopedic doctor (Charles Guilford?) are both running the 30K. Dave Westlake, the
hospital's health information and records manager, is running the 100-miler. The
Dayton Rescue Squad EMT who hooked up the serum IV works one of the aid stations.
We heard of several other members of the medical team that run or volunteer at
The volunteers at this race are experienced and superb.
A LONG NIGHT AT THE
Jim entered the hospital about 4:30 PM yesterday (Monday).
He was quickly stabilized but kept in ER for several hours to monitor his
response to both the poisonous venom and the anti-venom serum. He didn't exhibit
any symptoms of allergy or rejection. We met his attending physician, Dr. Susan
Snyder, before she left for the evening. She was attentive, thorough, and had a
wonderfully calming "bedside manner." Both she and Dr. Robinson explained why it
was important for Jim to remain at the hospital overnight. He wanted to go home,
of course, but understood why he had to stay there a few more hours.
Around 7 PM I went back to the camper (about 22 miles away)
to take care of the dogs and myself. Cody and Tater are fine left alone during
the day in the camper, but naturally they were happy to get out to "potty" and
eat their supper. I took a shower, ate dinner, and reorganized our running gear
and supplies. Before going to bed, I downloaded our e-mail, sent a letter to
Dave Westlake that Jim had written that morning (adding info re: the snake bite,
since he works at the hospital), prepared a bag of items for Jim, and went to
Neither of us slept well. I was concerned about Jim and he
was in a busy, strange place with a very sore leg, expecting nurses to come in
to poke and prod throughout the night (they didn't). His pain increased during
the evening, but was better by the time I arrived the next morning about 8 AM.
Hospital visiting hours are very open, so I was able to go on back to his room.
Dave was in the room talking with Jim, who was just finishing his breakfast.
I was relieved that Jim was in such good spirits despite
his ordeal. The swelling was down noticeably, it didn't hurt nearly as much when
Dr. Snyder touched his ankle and up his leg (photo below), and he was psyched
about being discharged soon:
More tests were run on his blood sample in the morning.
They all came out fine, indicating he was handling the situation well. Dr.
Synder prescribed an anitbiotic for five days (Augmentin) and a heavy-duty pain
killer that he probably won't use but will get just in case he needs it (later:
after being discharged, even occasional Ibuprofen was not needed).
Dr. Snyder told Jim it was important to elevate his leg as
much as possible until the swelling is gone. She recommended he ice the swollen
area for twenty minutes at a time, several times a day, to reduce the swelling.
The nurse (Connie) gave us contradictory written instructions about the use of
ice/cold packs, however, saying the staff's research found that icing is
contraindicated in snake bites. Since Jim was going to be seeing Dr. Snyder in
her office the next morning, he decided to follow her instructions to ice the
We waited patiently (?) for Jim to be discharged from the
hospital. He was in good spirits because the doctor was very optimistic about
his recovery. She didn't tell him not to run Bighorn, but said he'd have to use
his best judgment before and during the race. Even if the swelling is gone,
enough trauma has occurred to possibly increase swelling during the race. Some
swelling of the feet and legs occurs anyway, so he'll have to monitor himself
carefully. He is considering dropping down to a shorter distance or pacing me in
the 100-miler. I hope he'll be able to run his own 100-miler if he feels he can
Before we left, the hospital pharmacist came in to get more
information about Jim's bite and the race. Staff members are concerned about
being adequately prepared for other snake bite victims this summer, and with
about five hundred runners participating in the race soon, their antennae are
UP. The pharmacist indicated she'd be stocking up on more anti-venom serum "in
I believe this is the 15th year for the Bighorn Mountain
Wild and Scenic Trail Runs (5th year for the 100-miler). Race folks say they've
never had a snake bite during the race. That's good. Perhaps with so many people
out there, the snakes stay the heck off the trail!
We left the hospital about 9 AM and headed to
Wal-Mart to get Jim's prescriptions and some groceries. We stopped in the Sports
Stop to talk to Karen and Michelle Powers, who direct the race, but neither was
in. Jim was able to talk to Melanie, the woman who does the website, to tell her
about the snakebite so runners can be adequately warned. She put up a note about
it on the website message board. Jim and others added to the thread.
Rich Garrison and Karen stopped by our camper
later. They'd been clearing more trail and wanted to see how Jim was doing. We
also got a visit from Pat Shilling and his family. Pat lives half a mile from
the campsite in Dayton and is running the 30K. He's hesitant now to train up in
the nearby canyon. Jim and I don't intend to go back up there until race day,
This fella is still out there (we didn't kill
him). Here's his mug shot:
This was a lot more excitement than we
bargained for. We've learned some things about prevention and treatment of
poisonous snake bites and hope our cautionary tale will help to educate others.
We haven't been able to do much internet research yet, but I did scan a couple
websites about rattlesnake bites and came up with the following recommendations
for hikers and runners in rattler territory:
Be ever-vigilant. Jim and I were engrossed in
conversation and let down our guard after being wary for four hours.
Listen carefully. Don't wear headphones or
talk so much that you can't hear the distinctive rattling. We didn't hear it
this time, and rattlers don't always rattle, but we've heard them give notice
Don't sit on a rock or put your hands between
rocks without first visually determining for certain that there are no
snakes hiding there.
Run or hike with someone else in rattlesnake
territory. If Jim had been alone or 'way in front of or behind me, we wouldn't
have gotten to the hospital as quickly.
Carry a cell phone or have one in your vehicle
to notify medical personnel ASAP, even before you arrive. They may have to find
some serum from another hospital, and time is of the essence.
Be careful if your dog is running with you.
Better yet, don't take a dog into rattler territory unless (s)he's been
vaccinated for bites.
If help is close, stay as still as you can in
a safe location. If you have to go for help, as we did, walk out - DO NOT RUN.
The less the venom circulates through your system, the better.
Keep the affected body part (hand, foot) below
the heart level to decrease circulation.
Do your best to get the anti-venom serum into
your system within four to five hours of the bite to eliminate or reduce tissue
Jim and I were fortunate in this incident. We
were relatively close to our vehicle, the bite apparently wasn't as serious as
some, Jim was able to walk out OK by himself, we got to the hospital quickly,
hospital personnel went to work immediately on the serum problem, and he
received the treatment he needed in a timely manner. His excellent physical
condition also helped. This could have been a disaster if we'd been a lot
farther up the trail or unable to get proper medical care as soon as we did.
We are indeed grateful. And we will be more
careful next time!
Next: update on Jim's recovery, and fun
training on the upper portion of the course. Tune in for some moose photos soon
. . .