Why the use of Pressure Bandages is NOT recommended in East Africa snakebite first aid
We are occasionally asked for our opinion regarding the use of pressure bandaging in snakebite first aid. Our current position at Bio-Ken on its use is described below.
Many publications on snake bite treatment continue to advocate the use of pressure bandaging. This was first found to be useful in Australia where all the venomous snakes cause neurotoxic symptoms (which cause paralysis).
Even so, it was found that most people did not have sufficient stretchy bandage available within the first few minutes after a bite (it is useless if applied later as the venom spreads rapidly), and seldom knew how to apply it at the correct tension. As a result precious time was wasted which would have been better used in getting the patient to a medical facility.
In Africa, neurotoxic bites are very rare, by far, than cytotoxic bites (which cause painful swelling and, often, a lot of tissue damage). For this type of venom, adding extra pressure on a rapidly swelling limb is dangerous as the blood flow is already compromised and if the blood is cut off altogether it can cause gangrene to set in, leading to possible amputation or death.
About the only times one might consider using a pressure pad (as you can for a rapidly bleeding injury) would be if the victims sees a big, long grey or long bright green snake which makes off rapidly and the patient feels very dizzy & faint and breaks out in a cold sweat without much pain from the bite itself.
A pressure pad applied over the bite mark (a wadded shirt or similar can be used) and held down firmly by hand or sticking plaster that does not go all round the limb, may help to slow the spread of venom up the lymph glands without endangering the blood flow through the limb and could buy extra time while getting to medical help.
The large majority of snakebite patients that we see in East Africa involve Burrowing Asps (formerly known as Mole Vipers), Night Adders and Puff Adder bites that are predominantly cytotoxic. Most of the rest are Spitting Cobras also causing massive swelling and quite cytotoxoic.
Neurotoxic bites in Africa, caused by Mambas and Non-Spitting Cobras, are actually incredibly rare. The few we have seen have usually been a snake handler or someone who was trying to kill or catch the snake.
In conclusion, at Bio-Ken we recommend, for East Africa in particular, that pressure bandages in general should never be used. Only if one is really quite sure that the snake was a Forest or Egyptian Cobra or Green or Black Mamba could it be useful.
More snakebite info can be obtained from the Snakebite Section of our website. This includes PDF documents that can be downloaded and printed on the basics of snakebite first aid both in English and Kiswahili. You are welcome to use these if you wish.