Snakebite first aid in the United States

Call for help

Get emergency medical care as soon as possible, so that antivenom can be started if it is needed¹. Call 911 for an ambulance². Do not drive yourself to hospital, because a snakebite can make you dizzy or faint¹. Poison Help on 1-800-222-1222 is free, confidential and open 24 hours a day, and its experts can help work out whether the snake was venomous and tell you what to do next^3,4. Do not wait for symptoms to appear before getting help¹.

While you wait

These are the CDC’s first-aid steps while you wait for someone to take you to hospital¹:

• Keep calm, and if you can, take a photo of the snake from a safe distance¹.
• Lie or sit down with the bite in a neutral, comfortable position¹. Poison Control advises keeping the person quiet and still, with the bitten arm or leg at the level of the heart³.
• Remove rings and watches before swelling starts¹, and any tight clothing near the bite³.
• Wash the bite with soap and water, and cover it with a clean, dry dressing¹.
• Mark the leading edge of the tenderness or swelling on the skin, and write the time next to it¹.

What not to do

• Do not use a tourniquet^1,4. US emergency-medicine guidance notes that arterial tourniquets have proved ineffective, and sometimes harmful, in pit viper bites⁵.
• Do not cut the wound or try to suck out the venom^1,4. Cutting and suction do not remove meaningful amounts of venom and can worsen tissue injury⁵.
• Do not apply ice or soak the bite in water¹. Ice appears to be ineffective, and ice-water immersion has caused severe tissue injury⁵.
• Do not use electric shock or folk remedies¹. Electric shock has been shown to be ineffective and to cause significant tissue injury⁵.
• Do not drink alcohol as a painkiller, or take aspirin, ibuprofen or naproxen¹.
• Do not pick up the snake or try to trap it. Never handle a venomous snake, not even a dead one or its severed head¹.
• Do not use a pressure bandage or a constricting band: US guidance recommends neither for pit viper bites⁵.

How this differs from the general advice

US advice mostly agrees with the general first-aid page, with a few differences. The CDC asks you to wash the bite with soap and water and to mark the edge of the swelling¹, points the general page does not cover. It says to keep the bite in a comfortable, neutral position and does not mention a splint¹, whereas WHO’s general advice is to splint the bitten limb¹². The CDC lists aspirin, ibuprofen and naproxen as painkillers to avoid¹, while WHO says paracetamol (acetaminophen) may be given for pain¹². US guidance does not recommend pressure immobilisation for pit viper bites⁵, which fits WHO’s advice to keep the Australian bandage method for snakes that paralyse without causing local swelling¹².

In hospital

Antivenom is recommended for rattlesnake bites that show signs of progressive envenoming, such as worsening tissue injury or symptoms through the body¹. Two antivenoms are used for rattlesnake bites in the US: CroFab and Anavip⁶. After a copperhead bite, getting antivenom as soon as possible helps the limb recover faster¹. Poison centres work with hospital staff to make sure patients get the right amount, and the Wilderness Medical Society recommends that doctors consult a poison centre or a toxicologist^3,11. Coral snake antivenom exists but is no longer made and supplies are dwindling; poison centres help hospitals find it, and anyone with a suspected coral snake bite should be watched in hospital for at least 24 hours⁷. About 7,000–8,000 people are bitten by venomous snakes in the US each year, and about 5 die¹.

Snakes that matter here

The venomous snakes of the United States are rattlesnakes, copperheads, cottonmouths and coral snakes¹.

• Rattlesnakes live across most of the country; common species include the timber, Mojave, pigmy, Northern Pacific, eastern diamondback and western diamondback rattlesnakes¹⁰. Many rattlesnake bites need hospital care and antivenom¹⁰.
• Copperheads live in the eastern and central US. About 20–25% of their bites are “dry”, with no venom injected, and serious effects through the body are rare⁸.
• Cottonmouths, also called water moccasins, live near water in the South East. Their bites usually cause pain and swelling only⁹.
• Coral snakes include the eastern coral snake in Florida and the South East and the Texas coral snake in Texas⁷. Their venom affects the nerves; symptoms are usually delayed for several hours, then progress quickly and can stop breathing, although deaths are very rare⁷. Coral snakes account for only 1–3% of snakebites reported in the United States and Canada¹¹.