If someone is bitten

Updated

In this lesson: what to do, and what not to do, after a venomous snakebite, according to current medical guidance.

Most of the tips you may have heard for treating snakebites are out of date, ineffective, or actively harmful. There is a lot of incorrect information still in books and often repeated. This lesson follows the current guidance of the Wilderness Medical Society (updated in 2026) and the medical toxicologists who treat these bites every day. The first thing to know is the most important:

The two most important pieces of snakebite first-aid equipment are a set of car keys and a cell phone.

First, some perspective

Snakebite is frightening, and a venomous bite is a real medical emergency. It is also very rarely fatal in the United States. The CDC estimates 7,000–8,000 venomous snakebites per year and about five deaths. In the first three years of the North American Snakebite Registry, 450 bites were treated with modern care and not one patient died. Antivenom works. Your job is to get to it.

What NOT to do

  • Do not cut the bite and try to suck out the venom, with your mouth or with any device. The “extractor” kits sold in sporting goods stores remove essentially no venom and can make the wound worse.
  • Do not apply ice or cold packs. Cooling the tissue makes the local damage worse.
  • Do not apply a tourniquet, and in North America do not apply a pressure bandage or wrap the limb. (You may have seen pressure immobilization recommended for some Australian snakes. Current North American guidance advises against it for our pitvipers; coralsnake bites are managed differently and are not covered by that guideline, so follow Poison Control’s instructions.)
  • Do not use electricity, stun guns, or any similar folk remedy. Yes, people do this.
  • Do not drink alcohol or take aspirin or other anti-inflammatory painkillers (they can worsen bleeding). Acetaminophen is acceptable for pain if you have it.
  • Do not take antihistamines expecting them to help; they don’t.
  • Do not try to catch or kill the snake for identification. A second bite is a real risk, and a doctor can diagnose and treat a snakebite without the snake. A photo from a safe distance is nice to have, not necessary.
  • Do not wait to see if symptoms develop. Some bites are “dry” (no venom), but you cannot know that from home, and treatment is most effective early.

What TO do

  1. Get away from the snake. Three steps back. Then stop moving unnecessarily.
  2. Stay as calm as you can. Easier said than done, but panic raises your heart rate and helps nothing.
  3. Remove rings, watches, bracelets, and tight clothing from the bitten limb before it swells.
  4. Keep the bitten limb elevated, above the level of the heart if you can. (Older advice said to keep it low; that advice has been reversed for pitviper bites.)
  5. Call 911 or Poison Control (in the U.S., 1-800-222-1222, available 24 hours). Poison Control can tell you which nearby hospital stocks antivenom and can advise the emergency department before you arrive.
  6. Go to the emergency department. If someone can drive you, go. If you are alone or far from care, call for an ambulance rather than driving yourself; envenomation can affect your vision, coordination, and judgment. Call the hospital ahead if you can.
  7. Mark the swelling. If you have a pen, draw a line at the edge of the swelling and note the time. Doctors use this to judge how fast the venom is spreading.

At the hospital

Antivenom is the definitive treatment. In the United States it is safe, effective, and increasingly well understood; the days of dangerous horse-serum reactions are largely behind us. Not every bite requires it (many are dry or mild), and the decision belongs to the treating physician, ideally in consultation with a medical toxicologist. If your local hospital does not have one, Poison Control can connect them to one.

Whether you are bitten by a venomous or a nonvenomous snake, consider making sure you are current on your tetanus vaccination. Antibiotics are rarely needed for snakebite.

Plan before you need it

I advise everyone who spends time outdoors to know, before an emergency arises, the nearest hospital with antivenom on hand and the drive time to reach it. If you live somewhere remote, that number may be long, and knowing it is exactly why calling for an ambulance early matters more for you than for someone in the suburbs. Save the Poison Control number in your phone now: 1-800-222-1222.

Take this further

  • Sit down with the people in your household and go through the “do” list once. It takes two minutes.
  • For people who want the source itself, the Wilderness Medical Society guideline is linked below; it is written for clinicians but is readable.
  • Next unit: Language you can use with others.
Sources (4)
  1. Nicklaus Brandehoff, Spencer Greene, Jordan Benjamin, Sean P. Bush, Michael D. Cardwell, Alyrene Dorey, Jason Folt, Charles J. Gerardo, Geoffrey Smelski, Hank Song, Scott A. Weinstein, Nicholas C. Kanaan. 2026. Wilderness Medical Society Clinical Practice Guidelines for the Treatment of Pit Viper Envenomations in the United States and Canada: 2026 Update. Wilderness & Environmental Medicine. https://doi.org/10.1177/10806032261451823
  2. Anne-Michelle Ruha, Kurt C. Kleinschmidt, Spencer Greene, Meghan B. Spyres, Jeffrey Brent, Paul Wax, Angela Padilla-Jones, Sharan Campleman, ToxIC Snakebite Study Group. 2017. The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry. Journal of Medical Toxicology 13(4):309-320. https://doi.org/10.1007/s13181-017-0633-5
  3. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Venomous Snakes at Work. Accessed 24 September 2026. https://www.cdc.gov/niosh/outdoor-workers/about/venomous-snakes.html
  4. National Capital Poison Center. Poison Control (1-800-222-1222). Accessed 24 September 2026. https://www.poison.org/
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