First Aid and Pre-Hospital Management of Venomous Snakebites

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.

Snakebite in children in Nigeria: A comparison of the first aid treatment measures with the world health organization's guidelines for management of snakebite in Africa

“…Application of tourniquets is a common first aid practice among snakebite victims in Nigeria and other regions of the world. [ 7 28 31 36 ] The WHO guidelines strongly discourage the use of tourniquets as studies have shown that the use of tourniquet causes tissue anoxia and can trigger severe systemic envenomation after removal and experts recommend slow removal of already applied tourniquet to reduce these effects. [ 15 ] In addition, studies have shown that patients who used tourniquet required higher doses of antivenom and increased hospital stay.…”

“…Intravascular injections result in fast commencement of systemic toxicity and have poor prognosis even when antivenom is readily available. [ 36 ]…”

Paediatric snakebite envenoming: recognition and management of cases

“…Immobilisation of the bitten part of the body, in a functional position below the level of the heart, reduces lymphatic absorption of the venom. 20 The immobilised child should be transferred to a medical facility as quickly as possible, with the focus on airway and breathing support, prevention of aspiration (of vomitus or other fluids), oxygen administration and gaining intravenous access in an unaffected limb, 20 if available.…”

Anti-5 ′ -Nucleotidases (5 ′ Aslam1, Fatima2, Khalid3 et al. 2021BioMed Research International2000View full textAdd to dashboardCite

“…Drawbacks of conventional antivenom include adverse allergic reactions, inability to efficiently neutralize all clinical symptoms, and complex production processes that involve animal husbandry and extraction of snake venom. Timely transportation to rural areas is another problem as they usually lack proper medical facilities to stock and administer antivenom [22,23]. In this scenario, medicinal plants could be a viable and less costly option.…”