Administration Protocol for Universal Snake Antivenom After Snake Bite

First Aid Measures Before Antivenom Administration

The American Heart Association recommends activating emergency medical services immediately for any person bitten by a venomous or possibly venomous snake, and resting and immobilizing the bitten extremity to reduce systemic absorption of venom 1
The American Heart Association suggests removing rings and other constricting objects from the bitten extremity to prevent damage from swelling, and applying a pressure immobilization bandage with pressure between 40-70 mm Hg in upper extremities and 55-70 mm Hg in lower extremities around the entire bitten limb to slow venom dissemination by reducing lymph flow 2, 3

The American Heart Association advises against applying suction as first aid for snakebites, as it removes very little venom, has no clinical benefit, and may aggravate the injury, and also against applying ice to a snakebite wound as it may cause tissue injury 2, 3, 1
The American Heart Association recommends not using electric shock as it is ineffective and potentially harmful, and not applying tourniquets as they can worsen local tissue injury 1

The American College of Medical Toxicology recommends ensuring airway management and ventilatory support if needed, and establishing intravenous access before antivenom administration 4, 1
For common krait bites, the recommended initial dose is 10 vials of antivenom, according to the American College of Medical Toxicology 4

The type of snake venom affects treatment approach, with neurotoxic venoms requiring different treatment than cytotoxic venoms, according to the American College of Medical Toxicology 1
Pressure immobilization techniques may be more beneficial for neurotoxic snake bites than for cytotoxic snake bites, as suggested by the American College of Medical Toxicology 1

Delaying transport to a medical facility to attempt ineffective first aid measures can be harmful, as stated by the American College of Medical Toxicology 1
Failing to remove constricting items like rings can lead to ischemic injury as swelling progresses, according to the American College of Medical Toxicology 1
Excessive movement of the victim can increase venom absorption through the lymphatic system, as warned by the American College of Medical Toxicology 1
Using pressure immobilization techniques developed for neurotoxic snakes on cytotoxic snake bites can be ineffective, as noted by the American College of Medical Toxicology 1

Patients receiving polyvalent Australian snake antivenom should be continuously observed throughout the intravenous infusion and for at least 30 minutes after the infusion ends to promptly detect systemic hypersensitivity reactions, including severe events such as hypotension and hypoxemia. 5