Snakebite First Aid: What to Do and What Makes It Worse

This is general information, not medical advice. If someone has been bitten, call emergency services now — in the US, 911, or the Poison Help line on 1-800-222-1222 — and follow what they tell you.

Most snakebites in the United States are survivable and treatable. Deaths are rare, around five per year out of some seven to eight thousand venomous bites. What determines the outcome is largely how quickly someone reaches antivenom, and how much additional damage was done in the meantime by well-meant first aid.

At a glance

Do this

Call emergency services immediately. Do this before anything else. Antivenom is the treatment; everything else is buying time.

Move away from the snake. Get everyone, including the person bitten, out of range. A second bite is a real risk, and snakes do not always leave.

Keep the person calm and still. Movement speeds circulation. Have them sit or lie down and stay as still as practical.

Keep the bitten limb roughly at heart level. Current US guidance favours neutral positioning rather than raising or lowering it.

Remove rings, watches, bracelets and tight clothing right away. Swelling can be dramatic and fast, and jewellery that is not removed in the first few minutes may have to be cut off later — sometimes along with damaged tissue.

Mark the edge of the swelling with a pen, and write the time. Repeat every fifteen minutes. This gives the hospital a clear picture of how fast the envenomation is progressing and directly informs antivenom dosing. It is the single most useful thing a bystander can do.

Take a photo only if it is safe. From a distance, without approaching. Helpful but not necessary.

Get to hospital, even if it looks minor. Some bites are dry, with little or no venom injected — but you cannot tell early on, and coral snake symptoms in particular can be delayed for many hours before becoming severe.

Do not do this

Do not cut the wound. Cutting does not remove venom, introduces infection, damages tissue and nerves, and causes bleeding that is harder to control because pit viper venom interferes with clotting.

Do not suck out the venom, by mouth or with an extractor device. Suction devices have been studied and remove a negligible fraction of venom while causing local tissue damage at the site. Modern guidance recommends against them.

Do not apply a tourniquet or tight constricting band. This is the most harmful of the traditional measures. Concentrating venom in one limb segment increases local tissue destruction, and tourniquet use is associated with higher rates of amputation.

Do not apply ice or cold packs. Cold worsens tissue damage in an area already compromised by venom.

Do not give alcohol, caffeine, or painkillers containing aspirin or ibuprofen. These affect clotting or circulation. Paracetamol or acetaminophen is generally acceptable, but ask the dispatcher.

Do not try to catch or kill the snake. US hospitals use the same antivenom for all pit viper bites and treat according to symptoms rather than species. Catching the snake adds risk without adding information. A severed head can still deliver a reflex bite for a considerable time after death.

Do not use electric shock. This turns up in old advice. It does nothing and causes burns.

What happens at hospital

Staff will assess whether venom was actually injected, and how much. Roughly a quarter of pit viper bites are dry.

If envenomation is confirmed, treatment is antivenom given intravenously, dosed against how the swelling and blood work progress. Bloods are usually repeated over several hours because pit viper venom affects clotting, and effects can recur days later.

Coral snake bites are handled differently. Symptoms may be absent initially and then progress to muscle weakness and respiratory failure, so patients are typically admitted and observed regardless of how the bite looks.

Dogs and cats

Pets are bitten far more often than people, usually on the muzzle while investigating. The advice is the same: keep them calm and still, carry rather than let them walk, and go straight to a veterinary emergency service. Facial swelling can compromise the airway, so this is urgent.

Do not apply any of the human first aid myths to an animal either.

The thing that prevents most bites

Roughly half to three-quarters of snakebites in the United States happen to people who were deliberately interacting with the snake — handling it, moving it, showing it to someone, or trying to kill it. A substantial fraction involve alcohol.

Almost all of that is avoidable. Leave snakes alone, wear boots in snake country, know which species are local to you, watch where you put your hands and feet, carry a light after dark, and keep dogs on a leash on trails.