Here's a well done overview on snakebite management that addresses the Sawyer Extractor as well as the Australian pressure wrap technique. It has many informative links.
There is so little positive evidence of the Sawywer's efficacy, I am surprised at how many are willing to pack one "just in case it helps a little bit".
It is correct that there is little positive evidence of the Extractor's effaciacy. However, in the three of the studies I've read that that claim to disprove effaciacy, all of them waited 3 minutes and then applied the device for 30 minutes. They drew the conclusion that the device was simply not effective and also caused additional tissue damage.
As an engineer, if I were performing the same study, I would have made more narrow conclusions:
The device was not effective after a three minute wait; do not use it if three minutes has elapsed.
A 30 minute application causes tissue damage. It is not known if a shorter application time would reduce damage.
There is no point in keeping the device applied once three minutes since the bite has elapsed.
This would also compell further study. Repeat the study but with immediate application of the device. If any significant effeciveness is found, repeat the study to determine the effectivness over the range zero to 3 minutes delay. Finally, you could study the effects of varying application duration, but in any case it ought not exceed 3 minutes total.
Such a course of study would either conclusively prove that the device wasn't effective on snakebites at all in any situation or lead to a much better set of guidelines for its use that might reduce tissue damage.
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