Management of Snake Bites

Immediate First Aid Measures

Activate emergency medical services immediately after any venomous or potentially venomous snake bite 1, 2
Keep the victim calm and minimize movement to reduce venom absorption through the lymphatic system 2
Remove rings, watches, and other constricting items from the affected limb before swelling develops 1, 2
Apply a pressure immobilization bandage (40-70 mmHg for upper limbs, 55-70 mmHg for lower limbs) around the entire bitten limb, particularly important for neurotoxic snake bites from kraits and cobras 1, 3
A practical field estimation for proper pressure is applying a bandage tight enough to allow insertion of one finger underneath 3, 4
Immobilize the bitten extremity with a splint to further reduce venom uptake 3
Transport the victim to a medical facility as quickly as possible, as definitive treatment (antivenom) is only available in healthcare settings 2

Do NOT apply suction to the bite wound, as it is ineffective (removes only 0.04% of venom) and may actually increase tissue damage 2, 3, 4
Do NOT apply ice to the bite wound as it may cause additional tissue injury 2
Do NOT use electric shock as it is ineffective and potentially harmful 1, 2
Do NOT apply tourniquets as they can worsen local tissue injury 2
Do NOT delay transport to attempt ineffective first aid measures 1, 2

Antivenom is the cornerstone of treatment for venomous snakebites and should be administered as soon as possible 2
For common krait bites, the recommended initial dose is 10 vials of antivenom 1
Ensure airway management and ventilatory support if needed, particularly for neurotoxic envenomations from kraits and cobras which can cause respiratory paralysis 1
Establish intravenous access before antivenom administration 1

For neurotoxic envenomations (kraits, cobras), pressure immobilization technique is particularly beneficial 1
For cytotoxic/hemotoxic envenomations (vipers), pressure immobilization may be less beneficial or potentially harmful if it concentrates venom in one area 1, 2

Excessive movement during transport should be avoided as it increases venom absorption 2