It is clear that in many parts of the South East Asian region, snake-bite
is an important medical emergency and cause of hospital admission...
Most of the familiar methods for first-aid treatment of snake-bite, both
western and “traditional/herbal”, have been found to result in more
harm (risk) than good (benefit). Their use should be discouraged and
they should never be allowed to delay the movement of the patient
to medical care at the hospital or dispensary. Recommended first-aid
methods emphasise reassurance, immobilisation of the whole patient
and particularly the bitten limb and movement of the patient to a place
where they can receive medical care as soon as possible...
Antivenom is the only effective antidote for snake venom. It is an
essential element of treatment of systemic envenoming but may be
insufficient on its own to save the patient’s life. Antivenom may be
expensive and in short supply.
a. It is recommended that antivenom should be used only in patients
in whom the benefits of treatment are considered to exceed the
risks of antivenom reactions. Indications for antivenom include signs
of systemic and/or severe local envenoming.
b. Skin/conjunctival hypersensitivity testing does not reliably predict
early or late antivenom reactions and is not recommended.
c. It is recommended that whenever possible antivenom should be
given by slow intravenous injection or infusion.
d. Epinephrine (adrenaline) should always be drawn up in readiness
in case of an early anaphylactic antivenom reaction.
e. No method of preventing antivenom reactions has been proved
effective, including prophylactic epinephrine/adrenaline...