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eeek
Okay, so say one is out hiking alone and gets bit. What should one do?
It just isn't an easy question to answer and depends on many factors. Factors that come to mind that will tend to make snakebite outcome worse would include:
1. delay until care (walk out vs evacuation if available)
2. site on the body bitten (face is worse than extremity, I believe)
3. exercise or circulation of blood to area (walking out may worsen effects of leg bite, would need to immobilize if possible or be carried out preferably)
4. pre-existing medical illnesses (young healthy vs decrepit old dude)
5. associated other acute injuries (falls, burns, or fractures from reaction to snake bite or interventions by bystanders )
6. amount of venom injected (probably not measurable, except by observing reaction over time)
In a way, it is like having a heart attack--- rest is preferable but if it delaying initiation of care it can worsen outcome. Need to balance the benefit of rest against the delay in treatment. Most problems have a "golden interval" that would allow evacuation or escape, movement to a location that favors evacuation or signaling for help, or preparation for bivouac.
Scenario: Bite on leg while camping alone in Sierra incommunicado in a remote location
Probably most areas of the Sierra are within 5 miles of a trail junction or 10 miles of a trailhead. So the primary effort should be to signal for help or go for help if signaling (phone or other method) is not possible. If movement of the victim is necessary, I suppose that the movement/transport should occur early in the injury rather than later (in other words, better to attempt to walk out or walk to a more populated location early rather than waiting to decide how bad the bite will be or waiting an indeterminate interval to be found). I would try to minimize movement of the leg by using a splint or crutch and keep the leg a level of heart when resting but would attempt to get to a location where at least someone could go for additional help. If pain and swelling prevented movement, I would attempt to signal for help with fire/sound/ light as options exist and gather food, fuel, water, shelter and signaling resources for any long term bivouac plan.
Initially, I would clean the wound and apply dressing if available. If a prolonged delay in rescue is anticipated, then we would be talking least worst alternatives. Doing nothing except keeping bite area motionless at a level with the heart (neither elevated nor dependent) would probably be best for most people, although I have some ideas that I might personally try.
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