First aid measures for a snake bite

Question

If a person is bitten by a snake, what first aid measures should be taken to prevent the venom from spreading all over the body until the proper medical help arrives?

Answer 1

These are the steps that you want to take:

• If you can see the snake, be prepared to describe it. DO NOT attempt to catch it. If you can get a quick picture with a camera/cell phone, do so.
• Get the person out of biting distance of the snake. (Avoid getting bitten yourself)
• Keep the person calm, with the wound below the level of the heart, preferably lying down.
• Cover the wound with a loose sterile bandage.
• Call Emergency Medical or take the victim to an ER. Even if the person appears healthy, toxin effects can take several hours to appear, and early intervention is always better.
• If there is inflammation or swelling, trace around it with a pen. This can give an indication of reaction progression.
• Removed jewelry/rings/watches as swelling can prevent removal later. (Thanks to Shublu, I had forgotten this one).

If you are not near a civilized area (Such as hiking, backpacking, camping), several "tried and true" methods are not actually effective:

DO NOT

• Cut and suck: You can introduce venom into yourself, the cutting can spread the venom further, and you risk damaging underlying muscle/organs.
• Use ice: It doesn't prevent the spread of venom, and can cause frostbite if applied for too long
• Electrical shocks - Ineffective and can cause burns and/or stop the heart.
• Use alcohol - It may deaden pain, but will cause blood vessels to expand, increasing the spread of venom.
• Use a tourniquet/constriction band - Have not proven effective, and can cause more tissue damage and possibly cause limb loss if left on too long.
• Give aspirin - Aspirin is a blood thinner and can cause increase bleeding/spread.

Again, that is a list of ^^^WHAT NOT TO DO^^^.

The good thing about snake bites is that many bites do not actually envenom the victim, and of those that do, it may not be a full dose. Keeping calm and keeping the bite victim calm are going to be the best things you can do, as panic can cause other symptoms that may be mistakenly attributed to the snakebite.

Remember that children and small people are at a higher risk because of body size, as are people that are already compromised in some way health wise. Keep calm, make the victim comfortable and contact EMS or get to an ER.

Here is a fairly comprehensive review as published by the NIH (National Institute of Health, US-based entity) of the steps to take, as well as the listing of common venomous creatures encountered. My only contention is that if a person is exhibiting shock signs it recommends elevating the legs, but very often the leg is where the bite is. I would (personally, anyway) maintain a lying, neutral position in those cases.

However, while it recommends the use of a venom kit (Sawyer makes a very popular model) it has been shown in a study that such kits failed to remove any "venom" from the test site. (Further discussion at the Wall Street Journal).

Answer 2

In the case of snake bite, the protocol to apply varies slightly depending on the country. What follows is based on the guidelines provided by the National Health Service of England, the National Institutes of Health of the United States and the Ministry of Interior of France (this last document is the national team first-aid guidelines applied by firemen and certified volunteers. It is not translated in English, sorry about that).

A few contradictions exist between these sources regarding the position of the victim, the bandage to apply and the use of a pump suction device. I highlighted these contradictions in the protocol below. As I am certified in France, this protocol might be little "french oriented" though.

• Don't hunt the snake (don't risk another bite). Try to remember the snake's color and aspect as this will be useful information for the medical assistance.

• Keep the victim calm, reassure that snake bites can actually be handled at the hospital.

• Only if the area is not safe and cannot be secured, reach the nearest safe area. Movements should be minimized as much as possible.

• Make the victim lie down on the ground.
  (This is the French guideline. The American guideline instructs to keep the affected area below heart level unless there is a sign of shock, and the British guideline just say the bitten body part must stay as still as possible)

• Remove any jewelry or watches from the bitten limb as the affected area may swell.

• Loosen clothing if possible, but do not remove clothes.

• (US) Use a pump suction device should you have one
  (This is the American guideline. The French and English guidelines instruct NOT to use such a device, the word 'forbidden' is even used in the french guideline. It was really hard for me to write this bullet point as I would NEVER use a pump, personally)

• Should you be able to do so, monitor the victim's temperature, pulse, the rate of breathing, and blood pressure. Try do detect any signs of shock.

• Contact the medical assistance right away, even if the wound looks clean and is not painful as venom can take effect after hours. You should assume this is a medical emergency. So, without hurrying (very important! Being calm is gaining time):

  • Tell your name, phone number, current location,
  • Tell this is for a snake bite and tell the victim's gender and age
  • Describe the circumstances of the bite, including the snake's aspect, color and size.
  • Should you have monitored the victim's vital parameter above, list them.
  • Describe all that you did to the victim.
  • They will guide you in accordance with the protocol applicable in your country. This will certainly include an immobilization of the wounded limb and maybe a compression bandage. What they will tell you prevails on all what follows.
  • Do NOT hang up the phone until instructed to do so

• (FR) If possible, apply a compression bandage to the wound. It should not stop the blood circulation (tip: you should be able to insert a finger under the bandage).
  (This is the French guideline. American and English guidelines instruct NOT to compress the wound)

• Immobilize the wounded limb as instructed. It can be either a sling (UK, US), or a splint using a rigid support (UK, FR)

• Watch over the victim while awaiting the ambulance

There are also things NOT to do:

• Do not leave the victim on his/her own
• Do not cut the bite to extract the venom
• Do not suck the venom out of the bite
• Do not raise the wounded limb above the heart level
• Do not apply a tourniquet (Never. This may have terrible consequences!)
• Do not apply cold
• Do not give any medication
• Do not give anything by mouth, not even water
• Do not use any pump suction device
  (These are the French and English guidelines. American guidelines allow using such pumps, as seen above)
• Do not apply any compressive bandage
  (These are the English and American guidelines. French guidelines do recommend to apply such a bandage, see above)