What to Do After a Snakebite

What to Do After a Snakebite

As the weather warms up, serpents will start to slither out of their winter hideouts and, inevitably, cross paths with humans. Such encounters may end in a trip to the emergency room.

“Throughout the spring and summer months, the numbers (of snakebite-related ER visits) double, triple, maybe even more than that,” says Diane Calello, MD, an associate professor of emergency medicine at Rutgers New Jersey Medical School in Newark. “It’s certainly a warm-weather phenomenon.”

“Venom causes pain and swelling and perhaps some blistering at the site of the bite, and it damages tissue,” says Bret Nicks, MD, a professor of emergency medicine at Wake Forest Baptist Health in Winston-Salem, NC. “Large amounts can cause internal bleeding.”

In the U.S., venomous snakes fall into one of two types: pit vipers and coral snakes.

Pit vipers share many physical traits, such as triangular heads, vertical pupils, and a pit between their nostrils and eyes. The snakes in this category include:

  • Rattlesnakes: There are many rattlesnake species throughout the U.S. “Among pit vipers, rattlesnake venom packs the most punch and causes the most problems,” says Calello, who's also executive and medical director of the New Jersey Poison Information and Education System.
  • Copperheads: These venomous snakes live mostly throughout the eastern U.S., but their habitat stretches as far west as Texas. “If you’re going to get bit by a venomous snake, this is the one you want because it doesn’t do a lot to you,” says Nicks.
  • Cottonmouths (aka water moccasins): Cottonmouth snakes can be found in the southeastern U.S. The like to be near water.

Coral snakes, says Nicks, live mostly in Florida and Georgia. They are black and red with white or yellow bands.


Snake Venom

Pit vipers account for many more bites than coral snakes, but bites from either are not always poisonous. When they are, the amount of venom can vary. This is because snakes control the release of their venom: The greater the threat it perceives, the more dangerous its bite. Nicks says that one in four pit viper bites are “dry,” or free of venom, while 50% of coral snakes’ bites deliver venom.

You’ll know that you’ve been poisoned by a pit viper if pain and swelling appear around the bite. Snakes most often chomp down on the ankle or hand, says Calello, and symptoms will spread up the leg or to the shoulder, respectively. 

“The swelling and destruction can occur within an hour,” says Calello, “but the damage is generally not permanent if it’s treated.”

Left untreated, the tissue damage will get worse. That can lead to the loss of a limb or fingers, says Nicks, a spokesman for the American College of Emergency Physicians.

“If you have enough venom to cause large amounts of tissue damage, it can become gangrenous when the tissue dies,” he says.

Bites from coral snakes have few immediate signs to show that you’ve been poisoned. It can take 12 to 18 hours before serious symptoms set in. The venom, which contains neurotoxins, affects the brain’s ability to control the body’s muscles. Your speech may become slurred, and it may be hard to swallow. You could also get weak muscles, blurred vision, and paralysis. The poison can eventually make it difficult to breathe. That can be fatal, but only one death from a coral snake has been reported since the 1960s. Bites from these snakes don't happen often. In Florida, where coral snakes are most common, poison centers respond to fewer than 50 cases each year.


Best Practices

What to do -- and not do -- if a snake bites you:

  • DO Get to an emergency room as soon as possible. Even if the bite isn't poisonous, you’re at risk of tetanus, a serious bacterial infection, if your shot isn't up to date.
  • DO Move the limb where the bite happened as little as possible. This will help slow the spread of the venom.
  • DO Take note of the snake’s appearance. Your description will help the doctor identify what bit you. (Your location will also be a clue.)
  • DO Note the time the bite happened so the doctor knows how much time has passed.
  • DO Remove any jewelry around the area of the bite before swelling begins.
  • DO Use Tylenol for pain, if needed.
  • DO Keep contact information for poison control nearby. Call 800-222-1222, or text POISON to 797979 to save the number in your phone.
  • DO NOT Try to capture or kill the snake. You risk a second bite.
  • DO NOT Try to suck out the venom. It doesn’t work, says Calello, and it puts you at risk of getting poison in your mouth.
  • DO NOT Use aspirin, ibuprofen, or other painkillers that thin your blood.
  • DO NOT Apply a tourniquet. Cutting off blood flow to the area of the bite may cause more tissue damage, says Calello.



Treatment for a snakebite depends on the type of snake and how severe your response to the venom is. Mild cases may require only cleaning of the bite and observation to be certain you’re not likely to have further harm. You probably will also have blood drawn in order to test for any clotting problems caused by the venom.

In addition to first aid, observation, and blood tests, treatment of more severe bites requires anti-venom, which counteracts snake venom’s effects so that your blood can clot normally.


“The anti-venom that exists really does an amazing job at reducing your pain and swelling in the short term and improving your long-term outcomes,” says Nicks.

Coral snake anti-venom is also quite effective, but it is no longer being produced, and supplies are dwindling. And according to the FDA, current stocks of coral snake anti-venom will expire on Jan. 31, 2019.

Most people bitten by a coral snake can be treated successfully without anti-venom, but treatment could mean a longer hospital stay and assisted breathing. Nicks says that the emergency department should coordinate with the local poison control center to find out if anti-venom is available. Fortunately, coral snake bites are rare.

Anti-venom can cause an immediate allergic reaction, so you will be monitored as you get it. Some patients have a delayed reaction, called serum sickness, up to 3 weeks after getting the anti-venom. Symptoms include fever, hives, itching, and joint pain.

Expect about 6 to 24 hours of observation in the hospital, says Nicks. And be prepared for discomfort after you leave.

“Symptoms can last 1 to 2 weeks, on average, after treatment,” says Calello.



Of course, it’s best to avoid snakebites altogether, and you can do that by not provoking them.

“Snakes found in the U.S. are not aggressive and only bite when they feel threatened,” says Nicks. “They’re not seeking you out.”

Nicks and Calello recommend the following when in snake country:

  • Pay attention to where you walk. A snake likely won’t bite unless you step on it.
  • Avoid alcohol in order to remain alert. (And smart, adds Nicks: “Drinking may lead you to grab a snake and swing it around.”)
  • Carry a walking stick to tap the ground in front of you. If a snake feels threatened, it will be more likely to attack the stick.
  • Wear boots and long pants to protect your ankles.
  • Wear a headlamp or carry a flashlight at night so you can see snakes before you have a surprise encounter.

Top 5 things you need to do if you get bitten by a snake

1. Call an ambulance immediately

You should treat any snake bite as an emergency, regardless of whether you think the snake was venomous or not. Many snakes look similar, and if you wait to see if you feel symptoms of venom poisoning, it might be too late by the time you get help.

What to do

You need to stay as still as possible, so rather than running for a phone, use a mobile phone or have someone else go and call for help. Call Triple Zero (000) and ask for an ambulance, or use the Emergency+ app to call an ambulance. This app uses GPS functionality on mobile phones to help the emergency services know exactly where you are.

2. Don’t panic and don’t move

While it’s easier said than done, staying calm and still after a snake bite can help slow down the spread of venom in your body. If you’ve been bitten by a poisonous snake, not moving might save your life.

It’s a myth that snake venom gets straight into your blood stream after a bite. Instead, it moves through your lymphatic system. Lymph is a fluid in your body that contains white blood cells. Unlike blood, which is pumped around your body continuously, your lymph moves when you move your limbs. If you can stay still and calm, you can prevent the venom in your lymph traveling further into your body.

What to do

If you’re sure the snake has moved away after biting you and you’re not in danger of being bitten again, remain where you are, rather than walking to get help. If you’re with other people, they shouldn’t move you at all, but start administering first aid where you are.

Take long, deep breaths to help calm yourself down. Remember that the odds are in your favour: it’s rare for people to die after being bitten by a snake, especially if they follow first aid steps.

3. Leave the snake alone

Don’t try to identify, catch, injure or kill the snake – you’re likely to come off second best. At the hospital, staff have access to a range of tests that can help them determine the likely snake which you have been bitten by, enabling them to give you the most appropriate treatment.

If you are bitten by a snake and someone is with you, they should call for help and start first aid immediately.

4. Apply a pressure immobilisation bandage and splint

Most snake bites occur on a limb, so legs, feet, arms and hands are most commonly affected. If you’ve been bitten on a limb, applying a pressure immobilisation bandage can stop the venom moving through your lymphatic system.

What to do

If you’ve got a pad or even a piece of plastic like cling wrap, put it over the bite site to either soak up or protect the venom for later testing.

Apply a pressure immobilisation bandage by following the steps below:

  • use an elasticised roller bandage that is 10-15cm wide
  • roll bandage over bite site
  • apply a second elasticised roller bandage, starting just above the fingers or toes and moving upwards on the bitten limb as far as the bandage will reach
  • apply the bandage as tightly as possible to the limb
  • if you don’t have a bandage handy, any stretchy material will do (torn up t-shirts, stockings or other fabric can be used as a bandage)

Once the bandage is on, mark the bite site on the bandage with a pen or other substance that will leave a mark – if you’ve got nothing else on you, putting a little mud or dirt on the bandage will work. Then, splint the limb to keep it still. Any straight object will do – a stick, rolled up newspaper or even firmly rolled up clothes or tarps can all work. Fix the splint in place by securing it to the limb with bandages or other material.

If you’ve been bitten on your head, neck or torso, you don’t need to put on a pressure immobilisation bandage.

5. Don’t wash, suck, cut or tourniquet the bite

There are a lot of old methods of treating snake bites that are now known to cause more harm than good.

Washing the snake bite site can wash off venom that the hospital staff may be able to use to identify the type of snake that bit you. You should also keep clothing from around the bite site, because additional movement can cause venom to more readily move into the blood stream.

Do not suck or cut the bite area. Do not apply a tourniquet to the limb – this can be dangerous.