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SNAKEBITE EMERGENCY FIRST-AID INFORMATION

WHAT TO DO IF BITTEN BY A VENOMOUS SNAKE



  1. Allow bite to bleed freely for 15-30 secs.
  2. Cleanse and rapidly disinfect area with Betadine, assuming you're not allergic to iodine or shellfish) pad
  3. If bite on hand, finger, foot or toe, wrap leg/arm rapidly with 3" to 6" Ace or crepe bandage past the knee or elbow joint immobilizing it. Leave area of fang marks open. Apply Extractor immediately as well. Wrap no tighter than one would for a sprain. Make sure pulses are present. PLEASE READ DISCUSSION BELOW
  4. Apply Sawyer Extractor (see below) until there is no more drainage from fang marks.Extractor can be left in place 30 mins or more if necessary. It also aids in keeping the venom from spreading by applying a negative pressure against the tissue where the venom was initially deposited and creates a gradient which favors the movement of venom toward the Sawyer's external collection cup.
  5. If extractor not available: Apply hard direct pressure over bite using a 4 x 4 gauze pad folded in half twice. Tape in place with adhesive tape.
  6. Soak gauze pad in Betadine(tm) solution if available and not allergic to iodines
  7. Strap gauze pad tightly in place with adhesive tape
  8. Overwrap dressing above and below bite area with ACE or crepe bandage, but not too tight. No tighter than you would use for a sprain. Make sure pulses are present.
  9. Wrap ACE (elastic) bandage as tight as one would for a sprain. Not too tight.
  10. Check for pulses above and below elastic wrap; if absent it is too tight. Unpin and loosen.
  11. Immobilize bitten extremity, use splinting if available.
  12. If possible, try and keep bitten extremity at heart level or in a gravity-neutral position. Raising it above heart level can cause antivenom to travel into the body. Holding it down, below heart level can increase swelling.
  13. Go to nearest hospital or medical facility as soon as possible
  14. Try and identify, kill and bring ( ONLY if safe to do so) offending snake. This is the least important thing you should do. Visual identification/description usually suffices, especially in the U.S.
  15. Bites to face, torso or buttocks are more of a problem. Disinfect. Prep (shave hair) area with razor provided in extractor kit. Use extractor device until there is no further drainage possible and then apply pressure dressing with gauze pad and tape. ACE/crepe bandaging can not be applied to such bites. A pressure dressing made of a gauze pad may help if a Sawyer Extractor is not available.
  16. Antivenom is the only and best treatment for snakebite and you must get as much as is necessary as soon as possible. Antivenom administration should not be delayed. Up to 20 vials may be needed to neutralize the effects of rattlesnake and other crotalid venoms in North America. Children may need more than this as envenomation is apt to be much more serious in a small person compared to a larger one.



*For information on the pros and cons of using an ACE bandage or low-pressure dressing on a snakebite, see the discussion below.


What Not to Do if Bitten by a Venomous Snake



  1. Contrary to advice given elsewhere DO NOT permit removal of pressure dressings, Sawyer or ACE bandage until you are at a facility ready and able to administer antivenom. As soon as the dressings are released the venom will spread causing the usual expected problems of venomous snakebite. The hospital at this time must be prepared to administer the antidote (antivenom)*
  2. Do not eat or drink anything unless okayed by medical sources
  3. Do not engage in strenuous physical activity
  4. Do not apply oral (mouth) suction to bite
  5. Do not cut into or incise bite marks with a blade
  6. Do not drink any alcohol or use any medication
  7. Do not apply either hot or cold packs
  8. Do not apply a narrow, constrictive tourniquet such as a belt, necktie or cord
  9. Do not use a stun gun or electric shock of any kind
  10. Do not remove dressings/elastic wraps until arrival at hospital and antivenom available.
  11. Do not waste time or take any risks trying to kill, bag or bring in offending snake

*Remember ACE or other wide bandaging must not be wrapped so tight as to cut off systemic venous or arterial circulation. Properly applied such bandages will NOT compromise the systemic circulation.



WHAT TO TELL THEM AT THE HOSPITAL


  1. Ask Staff to Contact Poison Control Immediately
  2. Locate nearest Antivenom Resource (for N.A. species: Wyeth-1-610-688-4400)
  3. Ask staff to use physician consultants available thru Poison Control
  4. Alternatively contact Snakebite consultants through N.Y.C. Snakebite/Jacobi Hospital, Bronx, NY (Exotic Snakebites should also contact) Emergency Hotline at 1-718-430-6494
  5. Questions on snakebite may be posted to the venom list. If you are not a member please go to the VENOM LIST Website Or write the moderator to be subscribed at: venom@icomm.ca.


IT GOES WITHOUT SAYING BUT WE'LL SAY IT ANYWAY......

  1. Never hike, camp, work or collect specimens in areas where there are venomous snakes unless accompanied by at least two companions. One to stay with the victim and the other to go get help. All parties should know what to do.
  2. If you come across any snake in the field and don't know positively what it is or isn't, do not approach it, try and examine it or photograph it (unless you have a long telephoto or zoom lens). Move away from it as expediently as possible.
  3. If you work with venomous snakes in a public (zoo/exhibit) or private collection or in a museum or university laboratory, never open their cage without a companion nearby who is familiar with snakebite first-aid
  4. A telephone with an outside line should always be located in the room or area where venomous snakes are located in case there is a need to call for help.
  5. Never handle or attempt to handle venomous snakes without at least one trained companion present
  6. If you are not an experienced venomous snake handler, don't try handling or catching them without first obtaining extensive experience and training by someone who is trained
  7. If you maintain a private or laboratory collection of live venomous species, keep all cages under lock and key; rooms where such cages are located should have a double door and vestibule, be completely visible through glass paneling from the outside and be off-limits to all but authorized personnel. If a snake appears missing from a cage you may be able to locate it before entering the room in preparation of re-securing it. Such rooms should be completely sealed. No open or screened windows and no "mouse-holes" or pipe holes through which a snake can escape. Sink drains should be also be capped and toilets, if present, always kept covered.
  8. Finally if you deal with venomous snakes always make sure you have or know where to locate a supply of specific antivenom for the species you are involved with.



WEBSITES OF RELATED INTEREST

Poisons Information Database
Venom Listserv
New/Used Reptile-Herpetology BooksIncludes many titles related to venomous snakes and snakebite.


Herpmed's Homepage
Australia/PNG Snakebite Page
Wilderness EMS Institute
Herp Medical Page -- Go here for links to venomous snake and other snakebite website links.

This is for informational purposes and no liability is assumed in its use. Always consult with a competent medical professional regarding health related issues. Because of its rarity, some doctors know little or nothing about snakebite management so one should always request that they contact a Poison Control Center and ask to be placed in direct telephone contact/consult with a physician who is experienced in this area. A number of tragic deaths clearly have occured due to gross neglisence and medical mis-management as a result of this ignorance and failure to obtain competent consultative advice..