Managing snakebite
Ravikar Ralph, Mohammad Abul Faiz, Sanjib Kumar Sharma, Isabela Ribeiro, François Chappuis
Abstract
Bites from venomous snakes can result in bleeding, paralysis, long term disability, and death Immobilise the bitten limb when transporting the patient to a medical facility; the universal use of pressure immobilisation is controversial, and tourniquets are not recommended The 20-minute whole blood clotting test is a simple bedside test to screen for and monitor coagulopathy in resource-limited settings Assess vital parameters and initiate resuscitation measures if the patient is clinically unstable with signs of bleeding, shock, paralysis, or respiratory distress Intravenous antivenom is recommended in patients with systemic symptoms; the dose and type depend on likely snake species, local guidelines, and availability