Rationalisation of First-Aid Measures for Elapid Snakebite

Treatment of bites by adders and exotic venomous snakes

“…First aid for most exotic bites is the same as for adder bites (see above), but pressure-immobilisation (fig 5)20 21 is recommended for bites by snakes that can cause rapidly evolving and life threatening paralysis (most elapids except African spitting cobras and some Asian cobras).…”

British Military Snake-bite Guidelines: Pressure Immobilisation

“…Norris et al [29] suggest that the stress of a real snakebite could lead to higher PI application pressures (closer to those required), however, this is speculation and PI could in-fact be applied less tightly or securely and splintage could be omitted or applied ineffectively. PI without splintage is much less effective [13,22].…”

“…Sutherland et al [13] proposed PI as a method of delaying lymphatic venom movement following his research on monkeys. His experiments involved injecting immobilised monkeys with snake venom (Figure 1).…”

“…Following the publication of Sutherland et als [13] results, PI was widely adopted for snake-bite first-aid in Australia [12]. Published case reports seemed to confirm the benefit of PI in delaying systemic envenomation [17].…”

Snakebites in Africa and Europe: a military perspective and update for contemporary operations

“…Promising results were seen in laboratory studies in monkeys27 and, although never rigorously studied in humans, anecdotal case reports of rapid deterioration after removal of the dressing have been published 28–30. However, frequent reports also exist of inadequate application, loosening in transport and difficulties in training and effective application, even in Australia, where the method has been officially recommended since the 1970s 31–33.…”