Snakebite envenomation: first aid and rescue network

Snakebite envenomation is one of the most neglected tropical diseases according to WHO, and the harm caused by snakebite envenomation is immense.1WHO Guidelines for the management of snakebites, 1st edition. World Health Organization, Geneva2010Google Scholar, 2WHO Guidelines for the management of snakebites, 2nd edition. World Health Organization, Geneva2016Google Scholar David A Warrell and David J Williams discussed the problems in the management of snakebite envenomation in low-income and middle-income settings and gave practical guidance in a Seminar.3Warrell DA Williams DJ Clinical aspects of snakebite envenoming and its treatment in low-resource settings.Lancet. 2023; 401: 1382-1398Summary Full Text Full Text PDF PubMed Scopus (11) Google Scholar However, Warrell and Williams did not mention the role of first aid and pre-hospital rescue in the management of snakebite envenomation. First aid is the first-line treatment for snakebite envenomation; proper on-site management is very important to slow down the spread of venom, and might include helping the person with snakebite to maintain a calm state, compression of the bite location, and immobilisation of the whole body, particularly the affected limb.1WHO Guidelines for the management of snakebites, 1st edition. World Health Organization, Geneva2010Google Scholar, 2WHO Guidelines for the management of snakebites, 2nd edition. World Health Organization, Geneva2016Google Scholar As first aid is often done by the affected person or bystanders, community education of the general public is important, to avoid potentially harmful traditional folk methods, which might be prevalent in areas where snakebite is endemic. Since snakebite envenomation is a life-threatening emergency, I propose that management should be done within the confines of a regional pre-hospital rescue network, and the accessibility of pre-hospital rescue should be further improved. In accordance with experiences in trauma centres, the steps of the process from first aid to hospital management should be firmly linked, including the time from the bite to the first medical contact, the time from the first medical contact to the emergency department door, and the time from the emergency department door to the first administration of anti-venom. I declare no competing interests.