Back

Our family watched the new release of an old western ("True Grit") last night. The girl in the movie gets a snake bite and ends up losing her arm. The cowboy who rescues her does cut the snake bite open and suck the poison out. So why did she still end up losing her arm? I really didn't know how to explain it to the kids.

Untreated, poinsonous snake bites can kill people but this doesn't happen as often as most people think. Movies, of course, dramatize events like snake bites. The updated version of True Grit did an excellent job of portraying the need for emergency treatment. After administering first aid to the girl, the main character (Rooster Cogburn played by Jeff Bridges) rides with the girl until the horse gives out. Then he carries her through the night the rest of the way. In the end, her life is saved but her arm has to be amputated. In a real situation of untreated snake pit (or delayed treatment), the arm can develop a condition called compartment syndrome. The inflammatory response to the poison causes excess fluid and swelling. This fluid from the swelling gets trapped inside the osteofascial envelope. This envelope is a layer of connective tissue around the muscles, tendons, blood vessels, and nerves. The pressure placed on these sensitive soft tissues can cause death of the tissues. This condition is usually considered an emergency requiring immediate surgery to release the skin and soft tissues and let the fluid drain out. Today that procedure is called a fasciotomy. The events of the movie inferred that by the time the girl received medical care, necrosis and gangrene had set in. The only way to save her life was to remove the arm. Today, modern treatment with early surgical intervention and antibiotics has reduced the incidence of compartment syndrome considerably. Complications can still occur but amputation is not the usual final outcome.

« Back