My copy of Wilderness Medicine is at home, not the office so I don't have a good, "official" recommendation right now. IIRC, the best first aid is keeping the victim quiet, +/- on a snug, not tight band above the bite site (controversial), keeping the bite area cool(controversial) and transporting to the nearest hospital. Unfortunately, snake bites are a lot like appendicitis....there really isn't any first aid, only definitive care. <img src="/images/graemlins/frown.gif" alt="" />

A lot of bites are dry, and some only have minimal amounts of venom. Treatment with antivenom and supportive care is an ongoing clinical decision based on how a patient is doing.

Probably to simulate the time between "Oh crap, I just got bit by a snake!!" and actually finding the kit in your pack, opening it, reading the instructions you have forgotten and applying suction.

The Sawyer Extractor is regarded to be the best tool/ method... Keeping rattlesnakes is not, however, reccomended

Good advice, however here in Aus we use a constriction bandage from the bite site up the entire limb to the trunk of the body. Check circulation of blood in the digits.

As Susan points out, lymph is transported in a separate system by the action of the large muscle groups, so the leg/arm is immobilised (even splinted) and the patient is sat or laid down for transport to medical help.

The injection site / wound is not washed or cut. The bite site is marked on the bandage. This is so the medics at the hospital can save that portion of the bandage and "type and match" any venom on the limb or the bandage, to give the correct antivenom/antivenin. This means you don't have to touch or even see the snake.

Remember also that you will rarely get two perfect puncture wounds, and a small scratch may be the only evidence of potential envenomation.

For ant bites I have always found a baking soda paste to be effective.

I understand the pet thing. I raised a Burmese Python from infancy. Finally got so big (9 feet) that I had to get rid of him. He trashed the house making his rounds. When he finally discovered the warm electric blanket, there was no shooing him off the bed so I had to sell him back to the pet shop. I do miss him...............sorta.

I don't think I would want rattlesnakes having the run of the house. Besides, they BITE! Monty didn't. <img src="/images/graemlins/wink.gif" alt="" />

The latest philosophy according to the Docs that I work with:
Treat the symptoms.
The current treatment is to only give antivenom if you are suffering cardiac problems.
Anyone that works in an ED that is using a different protocol, please post.
BTW, Copperhead bites are the most common here, a few rattler bites, but not common.

What is recommended course of action if you're a) hiking solo, b) a couple of miles from vehicle, and c) bitten by a rattlesnake. Hike straight out, with no stops, and then seek medical help? Or should there be intermittent stops during return to vehicle? Does one vs. the other make any difference in rate of venom travel?

No way of knowing for sure. I would hike as fast as you can without getting your heart rate up. (good luck <img src="/images/graemlins/wink.gif" alt="" /> )

Here are a couple of more articles. I can't get the abstract online. Flipping thru 4th ed of Wilderness Medicine, the literature for or against the extractor is more anecdotal than experimental. There is one study I have read, but can't find now, that states the Extractor will concentrate venom near the suction site (instead of completely removing it) and this will lead to more local tissue damage.


Gellert GA
Snake-venom and insect-venom extractors: an unproved therapy.
N Engl J Med (United States), Oct 29 1992, 327(18) p1322



Gold BS
Snake venom extractors: a valuable first aid tool.
Vet Hum Toxicol (United States), Jun 1993, 35(3) p255

Forgey WW
More on snake-venom and insect-venom extractors.
N Engl J Med (United States), Feb 18 1993, 328(7) p516-7

Not all poisonous snake bites are deadly (at least in North America). I live in an area with a variety of poisonous snakes and grew up in an area litterally infested with several breeds. Snake bites are rare and death resulting from one is extremely rare. The best cure for a poisonous snake bite is not getting bitten. I only know of one breed of poisonous snake (water mocassin) in N America that is thought (might be urban legend) to be territorial and "may" attack a person. All the rest have to be kicked, stepped on, poked with a short stick, etc in order for them to bite. I grew up in the woods of East Texas and still spend much time in the woods. I have come across many snakes and even had a Copperhead as pet when I was a kid. I have never been bit (by a poisonous snake) and never known first-hand of anyone else being bit either. It is very rare. It is so much more rare than people think. I have also had a non-poisonous (ball python) wild snake as a pet and this snake I spent much time handling. Even in handling a snake regularly (at least this particular breed) you really have to do something to make them angry in order to get bit.