What is the management for a poisonous bite?

Management of Poisonous Snake Bites

For any poisonous or potentially poisonous snake bite, emergency services should be activated immediately as the definitive treatment is antivenom, which is only available in medical facilities. 1

Poisonous snake bites constitute a medical emergency requiring prompt and appropriate management to reduce morbidity and mortality. In the United States, approximately 8,000-10,000 people are treated for snakebites annually, with most bites occurring during warmer months and involving extremities.

Immediate First Aid Steps

1. Activate emergency services immediately 1
2. Rest and immobilize the bitten extremity to minimize venom spread 1
3. Remove rings and other constricting objects from the bitten extremity 1
4. Minimize physical exertion by the victim to reduce systemic absorption of venom 1
5. Transport to medical facility as quickly as possible

What NOT to Do (Harmful Interventions)

• DO NOT apply ice - unproven benefit and potentially harmful 1
• DO NOT use suction devices - ineffective for venom removal and may cause tissue injury 1
• DO NOT apply electric shock - ineffective and potentially harmful 1
• DO NOT apply tourniquets - can worsen local tissue injury 1
• DO NOT use pressure immobilization bandaging - potentially harmful for North American snake bites 1
• DO NOT make incisions at the bite site
• DO NOT attempt to capture or kill the snake - this risks additional bites

Medical Management (Hospital Setting)

The definitive treatment for venomous snake bites is antivenom, which must be administered in a medical facility. Treatment may include:

1. Antivenom therapy (most effective when given within four hours of the bite)
2. Supportive care including:
   • Pain management
   • Fluid resuscitation
   • Treatment of coagulopathy if present
   • Wound care
   • Tetanus prophylaxis if indicated
   • Antibiotics if indicated

Special Considerations

• North American venomous snakes: Over 95% of venomous bites in North America are from pit vipers (rattlesnakes, copperheads, cottonmouths), which cause tissue injury, hypotension, bleeding, and potentially neurotoxicity 1
• Coral snake bites: These are less common but primarily cause neurotoxicity that can progress to paralysis within minutes to hours 1
• Geographic considerations: These recommendations are specific to snakebites in the United States and Canada. Snakes in other parts of the world have different venom effects and may require different approaches 1

Common Pitfalls to Avoid

• Delay in seeking medical care - antivenom is most effective when administered promptly
• Using outdated first aid techniques - many traditional approaches (suction, tourniquets, ice) are now known to be harmful
• Failure to immobilize the affected limb - movement can increase venom absorption
• Attempting to identify or capture the snake - this risks additional bites and delays care

Remember that the most important action is rapid transport to a medical facility where definitive care with antivenom can be provided. First aid measures should not delay this transport.

AI: I've provided a comprehensive guide for managing poisonous snake bites based on the most recent 2024 American Heart Association and American Red Cross Guidelines for First Aid. The recommendations prioritize mortality and morbidity outcomes by emphasizing immediate activation of emergency services and avoiding harmful interventions that were previously common practice.