Sophia Price, with Cook Children's Trauma and Injury Prevention says Cook Children's Medical Center in Fort Worth reported its first snakebites of the season in late April and early May, including its first copperhead bite in May. In 2024, the Cook Children's Health Care System treated 30 snakebites, with the first reported in March.

Jay Pearson, P.A., a physician assistant with Cook Children’s Trauma Services, offers crucial advice for parents on keeping children safe from snakebites. Price recommends avoiding walking in tall grass and wearing protective boots. She also warns that at night, snakes may rest on warm surfaces like driveways or sidewalks. Price emphasizes that individuals should never attempt to touch or handle a snake, even if it appears dead.

North Texas is home to three species of pit vipers:

• Copperheads
• Cottonmouths (also known as water moccasins)
• Rattlesnakes

A snakebite can cause localized pain and swelling that may spread as venom progresses. Other symptoms can include nausea, vomiting, and an increased heart rate. In severe cases, patients may experience difficulty breathing, low blood pressure, or bleeding disorders.

If a snake bites a child, seek immediate medical attention at the closest emergency department.

What to do if bitten by a snake:

• Do not try to capture, photograph, or kill the snake.
• Do not apply ice, tourniquets, or attempt to suck out venom.
• Immobilize the affected limb and keep it at heart level if possible.

How snakebites are treated at Cook Children's:

Once at the hospital, patients with moderate to severe envenomation may receive antivenom, which is readily available at Cook Children’s Medical Center.

Patients are closely monitored for symptom progression and may require hospital admission for observation and supportive care. 

Last year, 35 children were treated for snake bites at Cook Children's, up from 21 bites in 2017 and 20 in 2016. Earlier in the week, a 19-month-old girl became the first child to be treated for a venomous snake bite at the medical center. She was admitted to the ICU and given three vials of anti-venom over the course of two days, according to Fox4News. The child is now recovering at home.

When children are taken to Cook Children’s Emergency Department, a careful snake bite protocol begins that can result in antivenom given to the patient.

"We have advance practice providers with years of experience and expertise in caring for snakebite victims as part of the Trauma Team," said Melinda Weaver, Trauma Program Manager at Cook Children's. 

The Trauma Team uses an evidenced based clinical guideline along with a scoring system, lab results and other indicators to decide if the antivenom is needed or not. If it's determined the antivenom is needed, the Cook Children's Pharmacy team is notified.

Cook Children’s Pharmacy carries one of the largest stocks of Crofab®, a snakebite antivenom treatment, in the area for rattlesnake, copperhead and water moccasin (cottonmouth) bites at all times.

Once the patient is brought to Cook Children’s, he or she is watched carefully for signs and symptoms to a venomous bite.

The initial evaluation of the patient includes the “A-B-Cs” (airway, breathing, circulation) and vital signs. The wound is then examined for swelling, discoloration and bleeding. Signs that the antivenom is needed include:

• Respiratory distress
• Nausea
• Vomiting
• Abdominal pain
• Bleeding from nose, skin or gums
• Tingling or prickling sensations
• Abnormally low blood pressure
• Faster than normal heart rate.

Ean Miller, a manager in the Pharmacy Clinic and a pediatric clinical specialist in the Emergency Department at Cook Children’s, said the signs that Crofab will be needed usually occurs within the first couple of hours.

“Once we know it’s a snake bite, we are immediately drawing the labs,” Miller said. “We will then assess the bite wound. One of the things that we watch for is if the redness and swelling around the bite starts to expand rapidly. If it’s not a venomous snake, usually there will be a little bit of redness and swelling but it doesn’t spread."

The initial care is administered by the Emergency Department and then the Trauma team at Cook Children’s takes over for treatment. An order is given if it’s determined the child needs the antivenom. The mixing takes 15 to 20 minutes by the pharmacist to get the antivenom ready.

The most important factors to giving CroFab are evidence of coagulopathy (blood clotting factors out of normal range) and evidence of respiratory distress, low blood pressure and fast heart rate.

If the patient responds to the initial dose and no allergic reaction occurs then an additional two vials will be given every six hours for three more doses.

Miller said 90 percent of patients start to improve after that first four to six vials of Crofab. Most of remaining 10 percent show improvement after an additional four to six for an almost 100-percent rate.

On rare occasions, a patient will develop an allergic reaction to the antivenom. If that happens, the patient cannot receive any more antivenom and treatment consists of symptomatic and supportive care.

Antivenom is not effective for the other venomous snakes in this country. Coral snakes, which also are in Texas, and other exotic species make up the remaining 1 percent of venomous snake bites in this country. Crofab® antivenom is not used to treat these bites. Patients are admitted to the hospital for 24-hour observation and supportive care.

About one minute outside was all it took for 1-year-old Harrison Bakke to be bitten by a baby rattlesnake. It happened just three feet from the door of his home in Abilene, Texas on Tuesday, June 26, 2018. He’s currently being treated at Cook Children’s.

This is the fourth patient treated for a snake bite at Cook Children’s this week and the fifth this month. According to the Cook Children’s Trauma registry, a total of 14 kids have been seen at the medical center for snake bites this year. Since 2010, 167 children have been treated for a snake bite.

Erin Bakke, Harrison’s mom, said she had just walked out of the room when her 3-year-old daughter opened the back door and both children stepped outside to play. Within no time, Erin heard Harrison crying. She ran outside and saw her son’s right hand bleeding.

She also saw the snake. Erin pulled both children inside and called 911. The fire department arrived to kill the snake and an ambulance took the little boy to an area hospital where he was administered the inititial doses of antivenom.

Harrison was then flown to Cook Children’s. He has received a total of 24 doses of CroFab at the time of this article's publication and is currently receiving two vials of CroFab (antivenom) every six hours. Surgery was also performed on his hand to make two small incisions to allow blood and fluid to drain from Harrison’s hand and reduce the swelling.

“A whirlwind would be the best phrase that for me would describe everything that’s happened,” Erin said. “We spent the first two hours at Abilene Regional Medical Center and it felt like we were there for 15 minutes. Everything was so chaotic, but at the same time everybody has done their job to keep our son healthy. I’m so thankful for everyone who has taken care of Harrison and the quick response.”

Erin and her husband, Michael, both run and walk in the neighborhood and have never seen a snake in the area. She said they live in a suburban area of Abilene and there’s not a lot of construction. Erin said she can’t believe this has all happened so fast because she only took her eyes off her children for such a short time before they made their way outside.

Texas Parks and Wildlife offers these tips for discouraging snakes from coming into the yard:

• Removing their shelter is one of the most effective ways of discouraging them.
• Eliminating rock piles, brush piles, and areas of tall grass will cause snakes to seek a more suitable habitat.
• Store lumber, wood piles and other debris around the home at least 18 inches off the ground.
• Controlling insect and rodent populations in the area will also help to discourage snakes by eliminating their food supply. Snakes will sometimes enter houses, barns and other buildings because they are attracted by the presence of rodents and insects as well as by the cool, damp, dark shelter provided by these buildings.
• To keep snakes out of houses or other buildings, you must seal off all entry points. Snakes usually enter a building at or below ground level.
• For this reason, all openings around water pipes, electrical outlets, doors and windows should be sealed. Any holes in masonry foundations around the home should also be sealed off with mortar.
• Hardware cloth or sheet metal can also be used to seal holes in wooden buildings or siding.
• As the weather heats up and kids are out of school, the opportunity for kids encountering snakes increases.

Mark Shelton, M.D., an Infectious Disease doctor at Cook Children’s and an Eagle Scout with the Boy Scouts of America, says it’s important to teach respect for snakes.

"If you ignore a snake, more than likely, the snake will avoid you,” Dr. Shelton said. “But kids being kids, that’s sometimes easier said than done. Talk to your children about staying away from the snake. Don’t try to pick it up or kill it. Teach your child not to touch it or walk near it. Children should stand still when they spot a snake, then turn around slowly and walk away. Usually, the snake will crawl away into the bushes.”

Sharon Evans, Trauma/Injury Prevention Outreach Coordinator at Cook Children’s, says it’s not just live snakes that pose a threat either.

"We’ve seen bites that occurred after a snake was killed. Often the parents or kids want to get a closer look at the ‘dead’ snake and the head still had the reflex to bite,” Evans said.

As the warm weather approaches, this is a good opportunity for parents to talk to their children about snake safety.

Here are nine tips to start the conversation with your child:

1. Don't touch a snake.
2. Don't try to kill a snake.
3. Ignore the snake if you see it.
4. Wear closed-toe shoes in wooded areas.
5. Don't put fingers under rocks or crawl under houses or other structures.
6. Don't canoe or boat under limbs on rivers, streams or lakes.
7. Avoid edges of lakes, streams and rivers where vegetation is high.
8. Instruct your children to notify you if they see a snake.
9. If bitten by a snake, seek medical help immediately. DO NOT open the wound or try to suck out the venom.

Four species of venomous snakes found in Texas: rattlesnakes, cottonmouths, copperheads, and coral snakes.

Rattlesnakes are most populous in dry areas with prevalent rocks and canyons. When threatened, rattlesnakes will curl into a defensive position and rapidly shake their rattles. Rattlesnakes can be recognized by the “rattle” apparatus at the end of the tail. This species of snake has scales in a distinct diamond pattern, as well as a large head and fangs. Depending on the location, rattlesnakes can vary in color from brick red, buff pink, straw-yellow, beige, brownish and light gray:

Cottonmouth snakes (seen on the right), also known as water moccasins, are found where prey is plentiful. These snakes require large basking sites and will travel far from water to hibernate. Cottonmouths spend the majority of their time coiled at the edge of bodies of water or draped over nearby vegetation:

Copperhead snakes are common in wooded areas from the hardwood bottomlands in east Texas, to woody patches in the Trans Pecos of west Texas. Additionally, copperheads can be found in open areas within short proximity of woods. During the summer, copperheads are most active at night:

Coral snakes are extremely common across the state, from the pine forests in the East to the oak juniper canyons on the Pecos River. These snakes thrive in urban, suburban, and other habitats with plentiful rock crevices or plant cover:

Mark Shelton, M.D., an Infectious Disease doctor at Cook Children’s and an Eagle Scout with the Boy Scouts of America, says it’s important to teach respect for snakes.

If you ignore a snake, more than likely, the snake will avoid you,” Dr. Shelton said. “But kids being kids, that’s sometimes easier said than done. Talk to your children about staying away from the snake. Don’t try to pick it up or kill it. Teach your child not to touch it or walk near it. Children should stand still when they spot a snake, then turn around slowly and walk away. Usually, the snake will crawl away into the bushes.”

Don’t be alarmed by the prevalence of these creepy crawlies within our great state, they love the sun and warmth just like us! Here are 10 tips to stay safe from snakes this summer:

1. Be especially careful of snakes after the rain. They will be seeking dry area and may be on a sidewalk or walking path they normally wouldn’t cross.
2. Don’t canoe or boat under limbs on rivers, streams and lakes.
3. Ignore the snake and they will ignore you.
4. Don’t touch or pick up a snake.
5. Don’t try to kill a snake.
6. Wear closed-toe shoes when in wooded areas.
7. Don’t put fingers under rocks and don’t crawl under houses or other structures.
8. Avoid the edges of lakes, streams, and rivers where vegetation is high.
9. Instruct your children to notify you if they see any species of snakes or other threatening animals.
10. If bitten by a snake, seek medical help immediately. Don’t open the wound or suck out the venom. Seek medical help.