What is the treatment for a snake bite?

Treatment of Snake Bite

Activate emergency services immediately and transport the victim to a hospital as quickly as possible, as antivenom—the only definitive treatment—is available only in medical facilities. 1, 2

Immediate First Aid Actions

Do these actions only if they don't delay transport:

• Rest and immobilize the bitten extremity to reduce systemic venom absorption through the lymphatic system 1, 2
• Remove all rings, watches, and constricting objects from the affected limb immediately to prevent ischemic injury as swelling progresses 1, 2
• Minimize the victim's physical exertion during transport, as walking and movement increase venom absorption 2, 3

Critical Actions to AVOID

The American Heart Association explicitly warns against these harmful practices:

• Do NOT apply ice or immerse in cold water—this has no proven benefit and may cause additional tissue injury 1, 2
• Do NOT use suction devices (with or without incision)—they are ineffective at removing venom and cause tissue damage 1, 2
• Do NOT apply electric shock—this is completely ineffective and potentially harmful 1, 2
• Do NOT apply tourniquets—these worsen local tissue injury and can cause ischemic damage 1, 2
• Do NOT use pressure immobilization bandaging in North America—this technique may worsen tissue injury from cytotoxic pit viper venoms that predominate in the US 1, 2

Understanding Snake Types in North America

Pit Vipers (99% of US venomous bites):

• Include rattlesnakes, copperheads, and cottonmouths 3, 4
• Cause cytotoxic effects: severe pain, progressive swelling, tissue necrosis, ecchymosis, coagulopathy, and potential hypotension 3, 4
• Symptoms develop rapidly at the bite site 4

Coral Snakes (1% of US venomous bites):

• Found in Southeast (Florida) and Southwest (Texas, New Mexico, Arizona) 1, 3
• Cause neurotoxic effects: paralysis developing within minutes to hours, with minimal tissue injury 1, 3
• Require monitoring for respiratory compromise 3

Hospital-Based Definitive Treatment

Antivenom is the cornerstone of treatment and must be administered in a medical facility 2, 5:

• Most effective when given within 4 hours of the bite 4
• Dosing depends on envenomation severity: mild cases may require 5 vials, moderate cases 10-15 vials, severe cases 15-20 vials 5
• Skin testing for hypersensitivity is mandatory before administration 4, 5
• Epinephrine must be immediately available for potential anaphylactic reactions 3, 5

Common Pitfalls to Avoid

• Delaying transport to attempt ineffective first aid measures—transport is the priority 2
• Failing to remove constricting items early—rings become impossible to remove as swelling progresses 2
• Excessive victim movement—this accelerates systemic venom absorption 2
• Applying techniques designed for neurotoxic snakes to cytotoxic bites—North American pit vipers require different management than snakes in other regions 2

Clinical Context

Approximately 8,000-10,000 snakebite injuries are treated annually in US emergency departments, with an average of only 6 deaths per year, demonstrating that rapid transport and hospital-based antivenom therapy are highly effective 3, 4.