The victims condition provides the best
information as to the seriousness of the situation.
The aims of first aid for envenomated snakebites
are to reducenot stopthe circulation of blood
through the bite area, delay absorption of venom,
prevent aggravation of the local wound, maintain vital
signs, and transport the victim as soon as possible to an
MTF with minimum movement.
TREATMENT OF SNAKEBITES.The
proper steps in the treatment of snakebites are listed
1. Try to identify the snake. Positive identification
is important to selecting the correct antivenom
for the treatment of the patient.
NOTE: Do not risk further injury by trying to
kill the snake.
2. Certain suction extractors have benefit (for
example, the Sawyer extractor), especially if
used within the first 3 minutes. If available
immediately, use the extractor and leave it on for
30 minutes. The cups may fill up. Empty and
re-use them as necessary.
3. GENTLY wash the wound with soap and water
(it may remove some of the venom). Do NOT
rub vigorously, as it may cause the venom to be
absorbed more rapidly.
4. Place the victim in a comfortable position.
5. Tell the patient to remove any jewelry
(especially rings and bracelets, as these may
impede blood flow if there is swelling of the
extremities). Assist, if necessary.
6. Start an IV line.
7. Monitor vital signs (including ABC+D&Es)
closely, responding appropriately as necessary.
8. Until evacuation or treatment is possible, ensure
the victim lies quietly and does not move any
more than necessary.
9. Do not allow the victim to smoke, eat, or drink
(Water is permissible if you
anticipate more than several hours will pass
before arriving at a hospital and being able to
establish an IV line.)
10. Transport the victim to a hospital or other
11. Place a lymphatic (light) constriction on the
extremity (if the bite is on an extremity). The
goal is to obstruct lymphaticnot blood-flow.
(See instructions below.)
DO NOT USE A
12. Splint the extremity at the level of the body
DO NOT ELEVATE THE
13. Hospitalize and observe all snakebites for at
least 24 hours.
In the case of spitting cobras (found in Africa,
Thailand, Malaysia, Indonesia, and the Philippines),
which attempt to spray venom into victims eyes, rinse
the eyes with large volumes of water (neither a blast
nor a trickle, and not with hot water).
antibacterial (tetracycline or chloramphenicol) eye
ointment, and apply a patch with just enough pressure
to keep the eyelid from blinking.)
Other aid will be mainly supportive:
Check pulse and respiration frequently. Give
artificial ventilation, if necessary.
Treat for shock, including IV fluids (normal
saline or lactated Ringers solution).
When possible, clean the area of the bite with
soap and water, and cover the wound to prevent
An appropriate lymphatic constriction device is a
blood pressure cuff, inflated to the diastolic blood
pressure (so the blood can be felt flowing past the
cuff). Other devices may be used, but IT IS
IMPORTANT THAT BLOOD CIRCULA-
Constriction should be fully released every 30
minutes for 15 seconds.
If the constriction
pressure cannot be carefully controlled, THE
MAXIMUM TOTAL TIME OF USE OF THE
CONSTRICTION DEVICE IS 2 HOURS.
(Thus, three 15-second breaks, and the fourth
time the cuff, belt, or band remains OFF.)
NOTE: If you use a blood pressure cuff (or
device that you KNOW is not constricting
more than an Ace7 bandage on a sprain), you
may continue to apply constriction until the
patient reaches a hospital.