TREATMENT OF SNAKE BITE
First Aid
First aid for snakebite is controversial. Many techniques are promoted or used around the world. Most have in common a complete lack of objective evidence of efficacy and often are associated with significant adverse side effects, varying from delay in obtaining appropriate care to directly related death. They therefore violate the principles of first aid for envenoming and cannot be recommended.

The only universally approved first aid for snakebite, applicable globally, is immobilisation of the bitten area/limb and keeping the victim still. For bites by non-necrotic species, including many Elapids (but not most cobras) and a few Viperids, the Australian-developed pressure immobilisation method is both safe and effective. The latter is based on retarding venom transport in the lymphatics, by applying moderate local and limb pressure sufficient to occlude superficial lymphatics and inhibition of the muscle-pump transport system by immobilising the limb in a splint. Applied correctly, it may be safely left on for several hours and experimentally is as effective as a tourniquet at preventing venom movement, but far safer. This technique has not been subjected to clinical trials, though extensive anecdotal evidence from Australia suggests it is safe and effective when used correctly. A modification of the technique has been trialled for viper bites in Myanmar and initial results suggest promise, with no increase in local tissue injury. If these studies continue to be successful and are extended to other necrotic bites, without evidence of increased necrosis, then the pressure immobilisation method may become the universally accepted first aid for all snakebites. That it is not presently accepted universally reflects concerns that immobilising necrotic venom locally may worsen the extent of necrosis and thus be counterproductive in treating the victim.

In general, the bite wound should be gently cleaned, except where bite site venom detection is available, as in Australia and New Guinea. Clear fluids may be given by mouth, but not food and certainly not alcohol.

There are a number of commonly used methods of first aid that are contraindicated, such as tourniquets, cut-and-suck and electric shock.