Snakebite First Aid: Immediate Actions & Critical Do Nots

Do not waste time on elevation debates. The only evidence-based first step for any suspected venomous snakebite:

IMMEDIATE ACTIONS

1. Call 911 / activate EMS immediately.
2. Immobilize the bitten limb at or slightly below heart level (splint if available).
3. Remove constricting items (rings, watch, tight clothing) before swelling progresses.
4. Keep patient calm, supine, still. Movement accelerates venom spread.
5. Mark leading edge of swelling with time every 15–30 min for ER tracking.
6. Note snake appearance (photo if safe) – but DO NOT attempt capture/kill.

ABSOLUTE DO NOTS

• ❌ Tourniquet / constriction band.
• ❌ Incision & suction.
• ❌ Ice / cold packs on bite.
• ❌ Electric shock.
• ❌ Alcohol, caffeine, NSAIDs (may worsen bleeding/thrombocytopenia).
• ❌ Herbal/folk remedies.
• ❌ Elevate above heart (increases venom return to central circulation).

Hospital Management

• Antivenom (CroFab / Anavip for crotalids; coral snake antivenom if indicated).
• Coagulation panel, CBC, fibrinogen, CK, renal function.
• Wound care, tetanus update, compartment syndrome monitoring.

Time is tissue. Every minute of delay increases morbidity. Transport to highest-level trauma center with antivenom capability.