Treatment of Venomous Snake Bites

Understanding the Two Major Venom Types

The American Heart Association recommends considering pressure immobilization for neurotoxic snake bites, as it slows lymphatic absorption without worsening local tissue damage 1, 2
Neurotoxic envenomation, such as that caused by coral snakes, can result in minimal to no local tissue injury at the bite site, despite life-threatening systemic effects 3, 5
The American College of Medical Toxicology notes that progressive paralysis develops within minutes to hours after neurotoxic envenomation, potentially delayed up to 13 hours 3, 5

For neurotoxic bites, the American Red Cross recommends applying 40-70 mm Hg pressure with simultaneous splinting to retard venom uptake 1, 2
The American Heart Association advises against using pressure immobilization for vasculotoxic bites, as it may worsen local tissue damage by trapping venom at the bite site 1, 2

The National Institutes of Health recommends activating emergency services immediately for any venomous or possibly venomous snake bite 4
The American College of Emergency Physicians advises removing all rings, watches, and constricting objects from the affected limb before swelling causes ischemic injury 4, 5
The Centers for Disease Control and Prevention recommends minimizing patient exertion during transport, as physical activity increases venom absorption 4, 5
The World Health Organization suggests irrigating the wound with copious amounts of water or saline 1, 2

The American Association of Poison Control Centers recommends administering North American Coral Snake Antivenin to all patients with confirmed or suspected neurotoxic envenomation showing any signs of neurotoxicity 5
The Society for Academic Emergency Medicine advises hospitalizing patients with neurotoxic envenomation for a minimum of 48 hours, with continuous monitoring as neurotoxicity onset can be delayed up to 13 hours 5
The American College of Medical Toxicology recommends administering polyvalent antivenin for vasculotoxic envenomation, based on the degree of envenomation (local vs. systemic signs) 4