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Recent Advances in Next Generation Snakebite Antivenoms
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First Aid and Pre-Hospital Management of Venomous Snakebites

Division of Toxicology, Department of Emergency Medicine, Brody School of Medicine at East Carolina University, Greenville, NC 27858, USA
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2018, 3(2), 45;
Received: 21 February 2018 / Revised: 15 April 2018 / Accepted: 16 April 2018 / Published: 24 April 2018
(This article belongs to the Special Issue Snakebite Envenoming: Prioritizing a Neglected Tropical Disease)
Background: Antivenom is the definitive treatment for venomous snakebites, but is expensive and not available in many rural and poorly developed regions. Timely transportation to facilities that stock and administer antivenom may not be available in rural areas with poorly developed emergency medical services. These factors have led to consideration of measures to delay onset of toxicity or alternatives to antivenom therapy. Methods: PubMed searches were conducted for articles on snakebite treatment, or that contained first aid, emergency medical services, tourniquets, pressure immobilization bandages, suction devices, and lymphatic flow inhibitors. Results: The reviewed articles describe how venoms spread after a venomous snakebite on an extremity, list the proposed first aid measures for delaying the spread of venoms, and evaluate the scientific studies that support or refute methods of snakebite first aid. The recommendations for field treatment of venomous snakebites will be discussed. Conclusions: The evidence suggests that pressure immobilization bandages and related strategies are the best interventions to delay onset of systemic toxicity from venomous snakebites but may increase local toxicity for venoms that destroy tissue at the site of the bite, so their use should be individualized to the circumstances and nature of the venom. View Full-Text
Keywords: snakebites; first aid; emergency medicine services; pressure immobilization bandages snakebites; first aid; emergency medicine services; pressure immobilization bandages
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Parker-Cote, J.; Meggs, W.J. First Aid and Pre-Hospital Management of Venomous Snakebites. Trop. Med. Infect. Dis. 2018, 3, 45.

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