First aid: Laypeople

First-aid treatment is carried out immediately or very soon after the bite before the patient reaches a health centre or hospital. It can be performed by the snakebite victim himself/herself or by anyone else who is present and knowledgeable.

• Vomiting and fainting very early (can happen within minutes),

• Swelling at the bite site (not in all snakebites!).

• Bleeding from the bite site and old wounds, the gums, vomiting of blood. Can start within an hour or later; even as late as 24 hours or more after the bite.

• Hanging eye lids, seeing things double, weakness in arms and legs, difficulty to breath as soon as 15-30 minutes and as late as 10 hours and more after the bite.

• Muscle pain within a few hours.

• Passing little or no urine after many hours or even days after a bite.

• the urgency of the problem.
• the expectation of signs & symptoms still to develop – very important to move quickly to a health post or hospital for assessment and observation. Move preferentially to a health post or hospital that has antivenom available!
• A safe time interval to exclude envenoming: at least 24 hours.

Stay calm

Reassurance will reduce fear and excitement, slow the victim’s heart rate, and reduces the spread of venom.

Immobilize the patient

Place the victim in a comfortable and safe position, ideally in the recovery position, and immobilize the bitten limb with a splint. Movement or muscular contraction, even undressing or walking, will increase absorption and spread of venom.

 CAUTION: Delay the release of tight bands, bandages, and ligatures.

If these, unfortunately still very popular methods of first aid were applied, they should not be released until the patient is under medical care.

Pressure pad

A rubber and/or folded material pad approx. 5 cm2 and 2-3 cm thick is placed directly over the bite site anywhere on the body and bound in place with a non-elastic bandage at sufficient pressure. Pressure of at least 70 mmHg - needs to be trained with the help of professional medical staff!!!

Immobilize the bitten limb with a splint

1. Locate and call the nearest hospital that has antivenom available.
2. Make sure that you ask specifically about antivenom availability and get confirmation.
3. Get their advice on how to tranfer the patient (they may have an ambulance or connect you to the ambulance service of the region)
4. If you have to tranport the victim on your own and the victim cannot move limbs, has "heavy" drooping eyelids or difficulties breathing you may need to stop at a health facility on the way to the hospital (with antivenom) to get support.

Transport the victim on a stretcher, "fire-man's lift" method, bicycle, motorbike, chart, horse, etc.

• A stretcher can be made with materials that are available in villages or at work.
• Transporting the patient with a stretcher avoids any movement that increases systemic absorption of venom.
• The recovery position will allow for vomit and other secretions to drain from the mouth with less risk of airway obstruction. This is particularly important when the patient is unconscious or semiconscious.
• Fix the patient to the stretcher with straps.
• Let somebody walk alongside the patient to continuously observe him/her.

Two-wheeler transport

• Support the victim between the driver and a pillion passenger
• Protected the victim’s legs from exhaust burns
• Drive safely
• All passengers should wear helmets!!

• Number of mobile phone
• Name of the caller (victim, first responder)
• Nature of snakebite envenoming (Unconscious? Difficulties breathing? Cannot lift head whilct lying on the ground? Bleeding)
• Name of the incident location
• Nearest place where the ambilance can get to the victim
• Never put down the phone/mobile, wait for the call agent for any medical information/pre-arrival instructions