Snake Bites and Swimming Holes

Snakes and chainsaws and sunburns, oh my! Along with the pleasures of summer activities come the dangers. Especially in rural areas, where hospitals are often further away than in the city. Here are some things to look out for when you're whooping it up out yonder.

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It’s spring now and all across the land things are bursting with life. Flowers are in bloom, yards are bright with new grass and the sun is high in the sky. My car was, for a while, covered in a thick, green coat of pollen. Carpenter bees are still turning my log-house into Swiss cheese. It’s pretty out, the sky is blue and the days are warm. Blah, blah, blah. I for one don’t really like this time of year. And it’s mainly because warm weather brings me patients with all kinds of injuries; some of them pretty nasty.

In rural America, there are dangers that seldom occur to people in more populous, metropolitan areas. Ironically, though, rural folks often assume that life in the city is more dangerous. And indeed, murder rates are higher. However, according to the CDC, deaths from unintentional injuries are 50% higher in rural than urban areas. These differences in death are due to several causes; rural citizens are further from necessary health care and are closer to large lakes and rivers, use dangerous equipment and firearms. Doubtless there are many factors involved in the difference.

Of course, some of the perils of rural life are just the result of living close to nature and all her deadly charms. In spring and summer we encounter creatures that bite and sting. Just last year, while mowing our lawn, we must have run over yellow-jacket nests at least half a dozen times. By the end of the summer I just let the grass grow. “You win!” I screamed to the little jerks, hiding in their holes. Whether it’s scorpions, hornets, wasps, centipedes, spiders or some other tiny monster, we simply encounter such creatures more in the warm months. And their various stings and bites, while rarely fatal, can cause dangerous allergic reactions. And make your spouse want to leave the area and move to a condo.

Fortunately, deaths from allergic reactions of all sorts are rare, only around 99 deaths per year in the US. Still, if you or your loved-ones are afflicted with such allergies, please talk to your physician about what to keep on hand; hopefully epinephrine injectors will get cheaper. And there are some other brands besides the ‘Epi-Pen’ that should be less costly.

Poisonous reptiles (copperhead, rattlesnake, cottonmouth and coral snakes) are also a feature of rural life in many areas. Those who “ooh and aww” in city zoo reptile houses rarely have the singular delight of encountering these wonders in their own yards or whilst walking through the woods. But these creatures, while important to the eco-system, can deliver nasty wounds and in rare cases can be lethal. They’re certainly dangerous to your finances given the cost of anti-venin to treat the bites. So be aware as you go about working and playing in places where snakes are also enjoying the summer sun or cool evenings.

Remember, too, that many snake bites occur because people are 1) intoxicated and 2) trying to mess with the snakes. And yes, ladies, this is a peculiar affliction of men that starts with, “Hey, betcha’ I can catch him!” Actually, I have it on good authority that snakes don’t even like the taste of drunk people and would like to be left alone, thank you very much.

Now, other dangers of rural life have to do with the necessity of power-tools. In my own life, the chain saw, weed-trimmer, and lawn-mower are absolutely essential to keeping nature from simply over-running our house. But as the dear reader knows, these are things to be treated with great respect. Please use appropriate protective gear, like safety glasses, gloves, appropriate clothes and heavy shoes. Of course, those who work on highways or farms use much bigger types of tools and heavy equipment and have to be ever watchful. This is probably more true in spring and summer because that’s when farms are busy, roads need to be fixed, bridges repaired, pipes laid, power-lines connected, houses constructed and all the rest. God bless all those folks who make our lives better by doing hard, dangerous work on the hottest of days.

And, of course, warm weather brings assorted recreational dangers. Hiking and camping are delights, but someone always manages to fall off of a waterfall or cliff-edge, break an ankle, sustain a laceration or encounter said biting and stinging creatures.

Bicyclists and motorcyclists look forward to warm months so that they can enjoy the open, dry road. But helmets really are important as is appropriate protective clothing, reflective material, and good education. I’ve seen patients who left their tanned skin on 50 yards of asphalt. Nobody enjoys that.

Lakes and rivers are warm, and filled with people who typically want to be dragged at high speed behind a power-boat while skiing, clinging to a large inflatable item for dear life, or kneeling on a wake-board. Likewise, fishermen head to their favorite spots (either in tournaments or alone for peace and quiet) and other aquatic persons kayak, canoe, and raft the rivers that draw so many to rural America for vacations. All of which is fantastic! But remember to learn to swim, always wear life jackets and follow local laws when doing all of the above.

Obviously there’s always the danger of heat exhaustion, heat stroke, dehydration and sunburn. We all have to remember to be careful to stay hydrated and remember that beer and caffeinated sodas don’t help. Also be reasonable about sun exposure and wear sunscreen to help protect against skin cancers.

And if the gentle reader wishes to avoid painful foreign bodies and sutures, here’s another bit of advice: Wear shoes all the time. Simple and to the point.

Spring and summer are glorious in rural America. But the dangers are many. I’ve only skimmed the surface here. Please remember to be safe, think before doing, follow the laws, don’t drink and boat, drive, ride, ski, pick up snakes, work with power-tools or do just about anything else. If you’re going to drink, find a chair and sit in it. That bit of advice would keep many an ER quiet all night long. Also remember that everything I said you shouldn’t do when drinking is something you shouldn’t do while taking narcotic pain medications.

I hope everyone has a great summer, free of emergencies. And that you can still be around when that first breath of cool air dips down from Canada and a proper season comes back once more.

Just please, please, be careful out there, OK?

(If you’re interested, here’s another link to a nice discussion of the unique injuries common in rural America.)

Edwin Leap, M.D., is medical director of the emergency department in a small North Georgia hospital. He lives in a log home in a remote part of Upstate South Carolina. Originally from West Virginia, Dr. Leap is married and has four children. Follow him on Twitter @edwinleap

 

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