Essential First Aid Procedures:
When someone has been bitten by a snake, reassure the victim who may be terrified. Reassurance is justified as most bites result in negligible or no envenoming and, even if a victim is envenomed, there is usually ample time to transport them to medical care. Deaths occur in hours after elapid bites, in days after viper bites. The majority of venomous snakebites may be managed without the use of antivenoms. Antivenom is best administered in a medical setting!
- Remove constricting clothing, rings, bracelets, bands, shoes, etc from the bitten limb.
- Immobilize the whole patient,especially the bitten limb, using a splint or sling. Muscular contractions anywhere in the body, will promote the absorption and spread of venom from the site of the bite via veins and lymphatics and all movements should be avoided as far as possible.
- Always keep the bite area below the level of the victim's heart to reduce the flow of venom.
- Cover the bite area with clean, moist dressing to reduce swelling and discomfort.
- Monitor the vital signs (pulse, temperature, blood pressure, breathing) of the victim. If there are signs of shock, lay the victim flat and cover with a warm blanket.
- Avoid the many harmful and time wasting traditional first aid treatment. Rejected or controversial first aid methods; Cauterization, incision or excision, tattooing, immediate prophylactic amputation of the bitten digit, suction by mouth, vacuum pumps or 'venom-ex' apparatus, instillation of chemical compounds such as potassium permanganate, application of ice packs (cryotherapy), 'snake stones' or electric shocks are absolutely contraindicated as they are all potentially harmful and none has proven benefit. Incisions provoke uncontrolled bleeding if the blood is incoagulable, may damage nerves, blood vessels or tendons and introduce infection. Suction, chemicals and cryotherapy increase the risk of tissue necrosis.
- Transport the patient as quickly and as passively as possible to the nearest medical care.
- Since species diagnosis is important, the snake should be taken along to hospital if it happens to have been killed. However, if the snake is still at large, do not risk further bites and waste time by searching for it. Even snakes which appear to be dead should not be touched with the bare hands but carried in a bag or dangling across a stick. Some species e.g. rinkhals (Hemachatus haemachatus) pretend to be dead (sham death) and even the fangs of a severed snake's head can inject venom!
What Not To Do:
- Do not wash, rub, massage or temper with the bite wound in any way (these interventions may encourage systematic absorption of venom from the site or introduce infection).
- Do not allow the victim to engage in physical activity such as walking or running. Carry them if they need to be moved.
- Do not apply a tourniquet to the area above the wound.
- Do not apply a cold compress to bite area.
- Do not cut into the bite.
- Do not give the victim stimulants and pain medications unless instructed by a medical physician.
- Do not raise the bite area above the level of the victim's heart.
- Do not suction the venom - doing so may cause more harm than good.