Snake Bite Survival/Field Treatment in North America

Basics
The easiest and best way to treat a snake bite is simply to avoid it. Wearing appropriate clothing such as boots, avoiding overgrown areas with poor ground visibility, avoiding picking up rocks or wood, and paying attention to your surroundings and where you are walking are the best ways to accomplish this. If possible before departing, steps should be taken to familiarize yourself with the area, what type of snakes are common, and ensure that you will have a cell phone signal or other effective means of communication. This preparation is crucial as there is currently no effective treatment for venomous snakebites that can be self-performed.

A few important things to understand are that most snakes in North America are not venomous, and those that are have “dry bites” that do not release venom in some instances; the incidence of this according to the data ranges from 2% to 50% but is believed to be under-represented in clinical studies due to under reporting. Due to a combination of factors including currently available medical care and “dry bite” fatalities from venomous snakes now are low, but without appropriate medical care they can easily kill, if not by the venom directly, but by the health complications and conditions it can rapidly cause. Put simply, it may not kill you, but it does constitute a medical emergency.


Steps To Take
1. Remain as calm as possible.

2. Try to see the snake that bit you for identification, note the color, size, head shape, and any distinguishing characteristics and if possible take a photo. Do not attempt to capture it.

3. If you have a cell phone with a signal or an alternate communication method, contact emergency services immediately and lie down with the wound below the level of the heart; proceed down this list and ignore step 8. If you do not have a cell phone with a signal, continue down this list and then proceed to step 8.

4. Remove any jewelry/watches from the affected limb.

5. If feasible, clean the wound with soapy water or another disinfecting agent as soon as possible.

6. If feasible, cover the wound with a clean/sterile dressing and splint it in an immobile position.

7. If feasible, using a marker or pen, draw a circle around the area encompassing the wound and any redness/swelling and note the time.

8. ONLY IF YOU ARE UNABLE TO CONTACT MEDICAL SERVICES you must at this point decide whether it is worth it to attempt to reach an area where you can contact medical services; if you are not experiencing any of the symptoms below, it may be better to stay put but if you are experiencing these symptoms, especially some of the more serious ones, it may be in your best interest to make the attempt.

There are also some things to avoid doing at this time, some of which will be expanded upon below. Do not tourniquet the limb, do not cut the wound, do not attempt to extract the venom, do not consume any alcohol, do not take any painkillers, and do not apply ice/cold packs. Fluids are permitted, but anything with caffeine should not be ingested as there is a desire to keep the heart rate low.

Symptoms of venomous snake bites to watch for include:
-Bloody wound discharge
-Excessive bleeding / lack of clotting
-Swelling at bite site
-Severe pain
-Discoloration
-Enlarged lymph nodes
-Diarrhea
-Convulsions
-Fainting
-Dizziness
-Weakness
-Blurred vision
-Excessive sweating
-Fever
-Thirst
-Nausea and vomiting
-Numbness and tingling
-Rapid pulse
-Altered mental state
-Shock
-Paralysis
-Breathing trouble


Common Mistakes/Misconceptions

Snake Bite Kits - Commonly sold snake bite kits are not a viable treatment for any kind of snake bites; almost all of these use some kind of suction device that will not remove much, if any, venom from a bite as the venom enters the bloodstream and does not stay in the area of the bite.

Pressure Immobilization - In some countries, a new treatment has emerged known as pressure immobilization. Current data suggests that while this may have some effectiveness for certain types of bites and venom, it is not recommended for use in snakes of the Crotalinae or Pit Viper subfamily of snakes which represent 3 of the 4 venomous snakes in North America as current evidence fails to prove a benefit versus the potential risks of the procedure.

Tourniquets - Tourniquets, especially in treatment of venomous snakebites in North America, are not currently recommended as there is little to no evidence of positive outcomes with this treatment method and some evidence of negative outcomes.

Incision - There are currently no quality studies to support any positive outcomes associated with making an incision across or at the snake wound; most, if not all, reputable organizations strongly recommend against this as it just opens another vector for infections and increases local swelling.

https://docs.google.com/document/d/1-H1FAM1EjfiMmKfC81NrUNqS3sQ2GTUyeKfbIYcbYPI/edit