Abstract
Background: Antivenom is the definitive treatment for venomous snakebites, but is expensive and not available in many rural and poorly developed regions. Timely transportation to facilities that stock and administer antivenom may not be available in rural areas with poorly developed emergency medical services. These factors have led to consideration of measures to delay onset of toxicity or alternatives to antivenom therapy. Methods: PubMed searches were conducted for articles on snakebite treatment, or that contained first aid, emergency medical services, tourniquets, pressure immobilization bandages, suction devices, and lymphatic flow inhibitors. Results: The reviewed articles describe how venoms spread after a venomous snakebite on an extremity, list the proposed first aid measures for delaying the spread of venoms, and evaluate the scientific studies that support or refute methods of snakebite first aid. The recommendations for field treatment of venomous snakebites will be discussed. Conclusions: The evidence suggests that pressure immobilization bandages and related strategies are the best interventions to delay onset of systemic toxicity from venomous snakebites but may increase local toxicity for venoms that destroy tissue at the site of the bite, so their use should be individualized to the circumstances and nature of the venom.
Highlights
Intravenous antivenom is the definitive treatment for venomous snakebites but is expensive, often in short supply, and not available in many rural and poorly developed regions [1,2]
This review will describe how venoms spread after a venomous snakebite on an extremity, list the proposed first aid measures for delaying spread of venoms, and evaluate the scientific studies that support or refute methods of snakebite first aid
Antivenom is the definitive treatment for venomous snakebites and should be administered as soon as possible after a bite
Summary
Intravenous antivenom is the definitive treatment for venomous snakebites but is expensive, often in short supply, and not available in many rural and poorly developed regions [1,2]. Transportation to facilities that stock and administer antivenom may not be available in areas with poorly developed emergency medical services. These factors have led to consideration of measures to delay onset of toxicity or alternatives to antivenom therapy. This review will describe how venoms spread after a venomous snakebite on an extremity, list the proposed first aid measures for delaying spread of venoms, and evaluate the scientific studies that support or refute methods of snakebite first aid. The recommendations for field treatment of poisonous snakebites will be discussed
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