First Aid for Pit Viper Snakebite

The best first aid: CAR KEYS!
  1. Stay as calm as possible, since an elevated blood pressure increases the absorption of venom.
  2. Identify the snake if possible. A photo, safely taken, can be useful.
  3. The snake's reflexes persist even after beheading. Bites have occurred by "dead" and decapitated snakes.
  4. Remove jewelry.
  5. If transportation is delayed, lightly splint / immobilize the extremity after marking and timing the leading edge of the swelling. Mark the leading edge every 15 minutes and include the time.
  6. Avoid any exercise if at all possible. Allow someone to carry you to transportation.
  7. Keep the extremity level to slightly below heart level. Do not elevate.
  8. If the Extractor® is used, limit it to one minute to prevent local tissue damage from the powerful suction.
  9. Do not eat or drink anything.
  10. Avoid making incisions and wrapping the extremity. Do not apply ice, heat, tourniquet, or electric shock.
  11. If a constricting band is in place, do not remove it (loosening may be required as the area swells, however). See NOTE below.
  12. Do not administer any medicines.
  13. If no ambulance transport is involved, transport to the nearest emergency room in a calm manner, obeying speed limits and traffic lights. Strive to keep the victim calm.

If in doubt, call contact Poison Control at 1-800-222-1222.

NOTE: The subject of constricting bands remains prevalent. Generally, no band should be applied because most victims can reach an emergency room before a life-threatening amount of venom can distribute. Time parameters regarding any application of a band are not very helpful because the important factor is venom load, which varies from none to heavy. Judgment is called for in deciding whether to apply a band. Generally, if one is becoming symptomatic and is hours away from help (again, an unlikely event) it may be reasonable to apply a less than firm band above the bite site on the extremity to slow the spread of venom through the lymphatic system, not venous or arterial. If a blood pressure cuff is used, the typical instruction of being able to insert a finger under the band/cuff means a pressure of only about 5 mm Hg. Once the band is applied it should not be removed except in the emergency room after antivenom is available; however, it may need to be loosened as the area swells.

The Book
“The ability of the venom to attack the blood coagulation cascade, coupled with the possibility of hypovolemic shock resulting from a shift of intravascular fluid into the tissues, constitutes the threat to the victim, but the attack on the blood coagulation cascade is the stealth bomber because coagulopathy cannot be felt.”