WILMINGTON, N.C. (AP) — As North Carolinians retreat indoors during this wave of extra heat, snakes are slithering out and about as the warmer temperatures push them from their hiding spaces.

And New Hanover Regional Medical Center is prepared for a wave of snake bites. Each year, staff members in the hospital’s emergency department have the opportunity to see venomous snakes up close and personal.

Dean Ripa, owner of the Cape Fear Serpentarium in downtown Wilmington and a professional snake handler, brings a collection of his snakes to the hospital each year so medical professionals can get a better understanding of the snake bites they see and how to treat them — especially during the summer when the emergency room sees an uptick in bite victims.

On a recent Tuesday, Ripa pulled an Eastern diamondback rattlesnake out of a carrying container in the hospital’s auditorium as a crowd of doctors, nurses, surgeons and other staffers looked on. The snake rattled and even lunged off the stage as Ripa calmly narrated what to do if bitten by the snake.

Along with being the only state east of the Mississippi home to all six venomous snake species found in the eastern U.S., North Carolina also has the dubious distinction of having the most venomous snake bites of any state in the country, according to the N.C. Cooperative Extension.

The New Hanover emergency departments treated 41 patients for snake bites in 2015 and have treated 29 so far this year at all of their locations, said hospital spokeswoman Claire Parker.

The snake symposium this week, Parker said, is a good opportunity for all the emergency department workers to see the types of snakes people may describe as they come in saying they were bit. The continuing education event is especially helpful for those new to the area who might not know about the venomous snakes in the region.

“You might think if you went to the Amazon that you would see a greater variety of venomous snakes, but that is not the case,” Ripa said, adding there are six species of venomous snakes in Eastern North Carolina but only three to four species in Brazil and the Amazon. Locally, there are three species of rattlesnakes along with the copperhead, water moccasin and the very rare coral snake. Coral snakes can really only be found near Carolina Beach State Park.

Because of the six different species located in the region, New Hanover Regional Medical Center keeps anti-venom treatments in stock year-round. The same treatment is used to treat bites for the rattlesnakes, copperhead — which is responsible for the lion’s share of venomous snake bites in N.C. — and water moccasin, also known as the cottonmouth.

“We typically watch and observe the patient for a few hours to see what symptoms develop,” said emergency department manager Terri DeWees. She said most symptoms are localized, and many patients come in with non-venomous bites. If symptoms persist or get more serious, DeWees said the decision is made to give the anti-venom.

But that option is expensive, with vials of the anti-venom costing thousands of dollars. Most treatments require multiple vials of anti-venom, which are administered in an IV along with liquids. Ripa said he knows of other snake experts who have gone through treatments that cost $450,000. With anti-venom treatments costing more than $25,000, add on a week-long stay in a hospital and continuous blood tests, Ripa said the costs add up.

If bitten by a snake, DeWees said to seek medical treatment as soon as possible so medical professionals can determine how serious the bite was after some observation. She said she encourages people to know what type of snake they were bit by because it helps medical professionals determine the course of treatment as well.

Despite the fact that some people shoot or kill the snakes that bite them and tote them into the emergency room as they check in, DeWees asks that victims please not do that.

“We would prefer people not bring in snakes,” she said.

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Information from: The StarNews, http://starnewsonline.com