Snake and Spider Bite First Aid: Pressure Immobilisation, Step by Step

Australia has a first aid technique that most of the world does not teach, for a reason that is worth understanding: snake venom mostly does not travel in the bloodstream. It moves through the lymphatic system, which is driven by muscle movement rather than by the heart.

That single fact is why our guidance looks the way it does. Bandage the limb firmly, splint it, and stop the person moving, and the venom largely stays where it is. ANZCOR notes that with pressure bandaging applied immediately and maintained, very little venom reaches the circulation even after several hours.

It is also why the folklore is dangerous. Cutting, sucking and tourniquets all come from a model of venom racing through the blood, and none of them are part of Australian guidance.

Snake bite first aid, step by step

1. Get the person away from the snake — move them, do not move the snake.
2. Call Triple Zero (000) and ask for an ambulance.
3. Keep them completely still and calm. Do not let them walk, not even a short distance. Movement is what pumps venom.
4. Apply a pressure bandage over the bite site.
5. Apply a second bandage from the fingers or toes upward, covering as much of the limb as possible.
6. Splint the limb, including the joints on either side of the bite.
7. Stay with them and keep watching. If they become unresponsive and are not breathing normally, start CPR — ANZCOR confirms there is no risk of venom passing to a rescuer during CPR. If they are unconscious but breathing normally, use the recovery position.

How to apply a pressure immobilisation bandage

This is the part worth reading before you ever need it.

• Use a broad elasticised bandage, 10–15 cm wide. Australian guidance prefers elasticised over crepe. If you only have crepe, or clothing torn into strips, use it — something firm beats nothing.
• Bandage over the bite first, then start again at the fingers or toes and work up.
• Cover as much of the limb as you can — the aim is the whole limb, not a patch over the bite.
• Get the tightness right. The test is simple: you should not be able to easily slide a finger between the bandage and the skin. As firm as you would strap a sprained ankle. It should not cut off circulation.
• Bandage over clothing if that is what is there — guidance says to apply it over existing clothing where possible rather than undressing the person.
• Splint the limb so the joints above and below the bite cannot bend. A stick, a rolled magazine, a tent pole.
• Mark the bite site on the outside of the bandage if you can, so the hospital knows where to look without unwrapping it.
• Do not take the bandage off. Bandages and splints stay on until a hospital removes them — taking them off releases the venom all at once.

What not to do

Australian guidance is explicit about these. Every one of them is still in circulation as folk wisdom.

• Do not wash the bite. Venom left on the skin can be used to identify the snake and choose the antivenom. Washing it away removes that.
• Do not use a tourniquet. Arterial tourniquets are specifically ruled out.
• Do not cut or incise the bite.
• Do not try to suck the venom out, by mouth or with a device.
• Do not try to catch or kill the snake. ANZCOR advises against it because of the risk of further bites — a large share of bites happen to people going after the animal.
• Do not let the person walk or drive themselves.
• Do not give alcohol or wait to see how they go.

Snake bite symptoms

Treat the bite, not the symptoms — but these are what healthdirect lists, and they are useful to relay to the call taker:

• At the bite: puncture marks that may be obvious or almost invisible small scratches; swelling, bruising or bleeding; severe pain that may take time to develop
• Breathing difficulties
• Irregular heartbeat
• Nausea, vomiting or abdominal pain
• Headache, confusion or dizziness
• Blurry vision
• Muscle weakness or paralysis

Snake bites should always be seen by a doctor even if the person seems well.

Spiders: why a redback is the opposite of a funnel-web

This is where a well-meaning first aider can do real harm. The two venoms behave differently, so the two treatments are different — and applying the funnel-web technique to a redback bite makes the pain worse.

The reason, in ANZCOR's own words, is that redback venom “acts slowly and any attempt to slow its movement tends to increase local pain.” A pressure bandage holds a slow, intensely painful venom in one place. So the rule of thumb: big and black gets a bandage; red stripe gets a cold pack.

If you did not see the spider and cannot say which it was, call 000 and describe what you saw.

When pressure immobilisation is used — and when it is not

The technique is specific to a short list of Australian bites and stings. Using it on the wrong one causes harm without benefit.

For bee, wasp and ant stings, the thing to watch for is a severe allergic reaction — see anaphylaxis first aid.

Ticks: freeze it, do not squeeze it

Ticks are the one in this article most people handle wrongly, usually with tweezers. Australian guidance from ASCIA and healthdirect is the opposite of the instinct:

• Freeze the tick where it is, using an ether-containing spray made for the purpose. It usually kills the tick within about five minutes.
• Then leave it alone and let it drop out on its own — which it should do within 24 hours. Take care not to compress or squeeze it while you wait.
• Do not use tweezers or hook-style tools. Gripping or disturbing a tick can make it inject saliva and its stomach contents into you.
• Do not use methylated spirits, kerosene, petroleum jelly or a lit match, and do not pull it out by force. ASCIA warns against all of these.
• If it will not come off, or you have nothing to freeze it with, leave it in place and get medical help to have it removed properly.

The paralysis tick causes most tick bites in eastern Australia, and reactions range from mild local swelling through to anaphylaxis. If someone has trouble breathing, facial or tongue swelling, or collapses after a tick bite, treat it as anaphylaxis and call 000.

Reducing the risk

• Wear boots and long trousers in long grass and bush, and use a torch at night.
• Never put a hand where you cannot see — woodpiles, under sheets of iron, into garden bags or letterboxes.
• Watch where you step around water and rock piles, and give any snake a wide berth. Most bites happen to people trying to move or kill one.
• Shake out shoes, gloves and washing left outside — classic redback territory.
• Keep a broad elasticised bandage in the car and the first aid kit. A 10–15 cm roll costs a few dollars and is the whole treatment.
• Check for ticks after bushwalking, especially along the east coast, including the scalp and behind the ears.

Related reading: what to say when you call an ambulance, anaphylaxis first aid, and preparing for a road trip in Australia. If you have an allergy or take a medication a retrieval team would need to know about, you can create your emergency profile in a few minutes.

Snake and spider bite FAQs

Sources

• ANZCOR Guideline 9.4.1 — Australian snake bite — management steps, the explicit list of what not to do, venom travelling by the lymphatic system, snake identification, and CPR posing no risk to the rescuer.
• ANZCOR Guideline 9.4.8 — Pressure immobilisation technique — bandage type and width, the finger test for tightness, bandaging over clothing, splinting, and which bites it is and is not used for.
• ANZCOR Guideline 9.4.2 — Spider bite — funnel-web versus redback management and the reason the treatments differ.
• healthdirect — Snake bites — symptoms, delayed pain, and treating every bite as potentially life-threatening.
• ASCIA — Tick allergy and healthdirect — Tick bites — freezing rather than squeezing, and the paralysis tick.

Disclaimer: This article is general first aid information, not medical advice or a substitute for accredited first aid training. In an emergency, always call Triple Zero (000). For poisons and envenomation advice, the Poisons Information Centre is on 13 11 26. For non-urgent health advice, call healthdirect on 1800 022 222 (NURSE-ON-CALL 1300 60 60 24 in Victoria, 13 HEALTH 13 43 25 84 in Queensland) or speak with your GP. MedibandPlus stores and provides access to a member’s own medical information; it does not assess, diagnose or treat any condition.

More first aid guides

• Anaphylaxis first aid
• DRSABCD: the first aid action plan explained
• How to do CPR: a beginner’s guide
• The recovery position, step by step
• Signs of stroke and the FAST test
• Calling an ambulance in Australia