What is the proper care for a venomous snake bite?

Proper Care for Venomous Snake Bite

For any venomous or possibly venomous snake bite, emergency services should be activated immediately, the bitten extremity should be immobilized, and rings or constricting objects should be removed while avoiding harmful practices such as applying ice, suction, electric shock, or tourniquets. 1, 2

Immediate First Aid Actions

• Activate emergency medical services immediately for any person bitten by a venomous or possibly venomous snake 1, 2
• Rest and immobilize the bitten extremity to minimize exertion and reduce systemic venom absorption 1, 2
• Remove rings and other constricting objects from the bitten extremity to prevent damage from swelling 1, 2
• Transport the victim to a medical facility as quickly as possible, as definitive treatment (antivenom) is only available in healthcare settings 2

Harmful Practices to AVOID

• Do NOT apply ice to the snakebite wound - it has unproven benefits and may cause tissue injury 1, 2
• Do NOT use suction devices (with or without incision) - they are ineffective for venom removal and may cause additional tissue injury 1, 2
• Do NOT apply electric shock - systematic reviews show it is ineffective and potentially harmful 1, 2
• Do NOT apply tourniquets - they can worsen local tissue injury according to human and animal studies 1, 2
• Do NOT use pressure immobilization bandaging in North America - it may worsen tissue injury with cytotoxic venoms that predominate in this region 1, 2

Medical Management

• Antivenom is the cornerstone of treatment for venomous snakebites and is only available in medical facilities 2
• In the hospital setting, patients should undergo comprehensive evaluation for hematologic, neurologic, renal, and cardiovascular abnormalities 3

Important Considerations

• Most venomous snakebites in North America (>95%) are caused by pit vipers (rattlesnakes, copperheads, and cottonmouths) which primarily cause tissue injury, low blood pressure, bleeding, and muscle problems 1, 2
• Coral snake bites (Elapidae) in the Southeast and Southwest US produce primarily neurotoxic effects rather than tissue injury and require specific management 2
• Excessive movement increases venom absorption through the lymphatic system, which is why rest and immobilization are crucial 2
• Approximately 8,000-10,000 people are treated for snakebites annually in the US 1, 2

Common Pitfalls to Avoid

• Delaying transport to attempt ineffective first aid measures - prompt medical attention is critical 2
• Using outdated first aid techniques like tourniquets, incision and suction, or cryotherapy that were previously advocated but are now known to be harmful 4
• Failing to remove constricting items like rings, which can lead to ischemic injury as swelling progresses 2
• Using pressure immobilization techniques developed for neurotoxic snakes on cytotoxic snake bites, which predominate in North America 2