From the Guidelines
If you're bitten by a snake, seek immediate medical attention by calling emergency services or going to the nearest hospital. While waiting for help, keep the affected limb immobilized and positioned below heart level to slow venom spread, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. Remove any constricting items like jewelry or tight clothing near the bite area, as swelling of an envenomated limb may cause rings to constrict and damage the finger 1. Clean the wound gently with soap and water if available.
Do not apply tourniquets, cut the wound, attempt to suck out venom, apply ice, or give the victim alcohol or pain medications, as these methods are potentially harmful and have no proven benefit 1. The use of suction, electric shock, and pressure immobilization bandaging are also not recommended, as they may cause tissue injury and have unclear benefits 1. Try to remember the snake's appearance to help medical professionals identify it, but don't waste time trying to capture or kill it.
At the hospital, treatment typically involves antivenom administration if the snake was venomous, along with supportive care including IV fluids, pain management, and monitoring for complications 1. Prompt medical treatment is crucial as snake venom can cause tissue damage, bleeding problems, and in severe cases, respiratory failure or death. It's essential to note that approximately 8000 to 10,000 people are treated for snakebite in the United States each year, and most venomous bites in North America are caused by crotaline snakes (Crotalinae, also known as pit vipers) 1.
From the Research
Treatment for Snake Bites
- The main treatment for venomous snakebites is antivenom, which is effective in counteracting the venom [(2,3,4)].
- Antivenom is indicated in cases of progressive venom injury, which includes worsening local injury, coagulation abnormalities, or systemic effects 2.
- The administration of antivenom should be done intravenously, and skin testing is mandatory before administration to predict the possibility of anaphylactic reaction 3.
- Patients with mild envenomation may require up to five vials of antivenin, while those with moderate or severe envenomation may require more 3.
Immediate Care
- Immediate treatment for snakebite includes limiting movement and placing a constriction band proximal to the site of venom injection 4.
- If medical care is more than 30 minutes away, the wound may be incised and suctioned, but this should only be done by experienced personnel 3.
- Cryotherapy is contraindicated, and incision and suction should not be performed unless necessary 3.
Additional Treatments
- Broad-spectrum antibiotics should be administered to prevent infection, and tetanus status should be determined and tetanus toxoid administered if necessary 3.
- Pain medication, diazepam, and plasma expanders may also be given as part of the treatment 4.
- Fasciotomy is only indicated in rare cases involving elevated intracompartment pressures 3.
Global Situation
- The true global incidence of envenomations and their severity remain largely misunderstood, and there is a need for globally-coordinated action to improve snakebite treatment [(5,6)].
- Research is ongoing to develop more efficacious, safe, and affordable treatments for snakebites 6.