What is the Best First Aid for Snake Bites?

QUESTION: With a camping trip coming up, and having read an article or two, I
thought this question was appropriate for your column. What is the best first
aid for snake bites?
------------------------------------------------------------------------------
ANSWER: It certainly is appropriate, for I have received more than one letter
asking a similar question. And I've answered it before, only to find dozens
of new letters with differing opinions, ideas and techniques. Obviously
there's more than one way to handle the situation but here are my thoughts.
The first thing you should do when someone is bitten by a snake is to
remove or loosen any tight clothing the victim is wearing, calming the patient
and making him comfortable. The next major step, if possible, is to determine
what type of snake made the bite. If you're certain the snake is
nonpoisonous, cleansing the wound carefully, and an antitetanus injection
when available, should be sufficient treatment. However, if the snake is
poisonous or can't be positively identified, the best thing to do is to
immobilize the affected area and rush the victim to the nearest medical
facility. If the bite is on an arm or leg, try to keep the extremity below
the level of the heart during transport. Time is critical when dealing with
venomous snakes, and since different bites require different antivenins for
treatment, it is very important to seek professional assistance as quickly as
possible.
In the past, making an incision in the wound and sucking out the venom
was the advised treatment, but an unskilled person may do more harm than good
when he starts slicing at the wound with a knife. Therefore, incision
techniques are not advised unless medical care is not going to be readily
available. In such cases, the incision should be made across the fang marks,
extending only slightly beyond them, and penetrating only through the skin
surface. The incision must be made within fifteen minutes to be effective.
Since this technique is useless with coral snake bites, I feel it is important
to stress the need for identifying the type of snake that inflicted the bite.
The key to treatment and what techniques to use depend on it.
Today, first aid treatment includes the use of a suction pump that
creates an atmosphere of negative pressure on a bite wound. No incisions are
required, and though it comes with a compression band, the suction can be
effective without it. For the best results, the suction should be used within
minutes of the bite, and its effectiveness is sometimes increased by making
small puncture incisions in the fang wounds prior to extraction.
Pouring alcohol on a snake bite is useless because its vasodilating
properties can actually cause more harm than good. Ice packs, once believed
to reduce venom potency, are no longer advised either. They can actually
cause local tissue destruction. Carrying antivenin is sometimes advised, but
knowing what type to use and when is important, and there is always a risk of
anaphylaxis (severe allergic shock).
Because of the risks and the need for different treatment, the best
advice concerns preventive measures. If you are going on a camping trip,
familiarize yourself with snakes indigenous to the area. Wear boots or
leggings that fangs can't penetrate. Shake out sleeping bags, bedding, and
footwear before using them, and use caution around sheds and outhouses where
snakes are likely to be. And, as most experts agree, would-be rescuers can
best be of help by getting the victim immediate medical help.