+1 to what bmisf is saying. I took a Wilderness First Aid course last year. They advised us that any suction was ineffectual and could actually make things worse. There really wasn't much that one could do in the field for a snake bite victim, just clean the wound, cover the wound with a sterile dressing, keep the victim as calm as possible, and evacuate ASAP. Antivenom is really the only effective means of treatment, which is not especially good for those of us who like to wander "off the beaten track." Perhaps yet another really good reason to carry a PLB?

It's a valid point that the test cited has some flaws, but I wonder if that particular study is what the "no suction" advice is based on. Is that the only study out there? Did that study result in the "no suction" recommendation? I'm not saying the study isn't relevant, but it's a least worth asking what other factors were included in the "no suction" recommendation.

"...elevation of the bitten limb if possible..."

Elevation? Isn't that just going to help any venom flow toward the heart faster???

IIRC, we were instructed to keep the extremity below the level of the heart, but maybe elevation would reduce the blood flow and thus the rate of propagation of the venom?

Elevation is used to slow bleeding so as to assist the coagulation process. Elevation above the heart's level.

I know that I was taught to keep the limb below heart level as much as possible. Elevation to help slow bleeding. But then I have been out of the loop for a while, and medicine is changing all the time, that is why doctors have a "practice"...

Heck, if you get bit by a deadly snake, just cut the problem limb off, that will stop the flow of poison to the rest of the body...

lol. Now why didn't I think of that.

My apologies; the recommendation is to keep the bite at approximately heart level - I can no longer edit my original post (which I'd love to do to make sure it's accurate). The idea is to balance minimizing swelling and venous flow.

Here's the update from the school I trained with:

http://www.nols.edu/wmi/curriculum_updates/archive/041105_sawyer.shtml

Good update. NOLS certainly has a lot of credibility.

This little bit is a bit disconcerting. If one is miles into the wilderness, carrying someone out is going to be tough, particularly in steep, brushy, snow-covered, or other difficult terrain. A big group would be helpful inasmuch as you could rotate the carriers to prevent exhaustion, but I ususally hike with one or two other guys, hardly a group big enough to have effective rotation.

I'd definitely be pulling out my PLB, particularly if I were multiple days away from the nearest trailhead.

I agree. That the study has some flaws doesn't mean there isn't other good information out there to recommend against using the Sawyer extractor. I've read varying accounts on the effectiveness of the device. I wonder if some of the variables I mentioned are factors in that.

As for the whole circulation question, one of the things I read some time ago made the point that letting the poison circulate has the potential benefit of dilution. The more the poison is allowed to spread and dilute, the weaker its effect in those areas to which it has spread. The reality may simply be that for every person and bit combination that somewhat different treatments may be optimal.