1. Allow bite to bleed freely for 15-30 seconds.

2. Cleanse and rapidly disinfect area with Betadine, assuming you're not allergic to iodine or shellfish) pad

3. If bite on hand, finger, foot or toe, wrap leg/arm rapidly with 3" to 6" Ace or crepe bandage past the knee or elbow joint immobilizing it. Leave area of fang marks open. Apply Extractor immediately as well. Wrap no tighter than one would for a sprain. Make sure pulses are present.

4. Apply Sawyer Extractor (see below) until there is no more drainage from fang marks. Extractor can be left in place 30 minutes or more if necessary. It also aids in keeping the venom from spreading by applying a negative pressure against the tissue where the venom was initially deposited and creates a gradient which favors the movement of venom toward the Sawyer's external collection cup.

5. If extractor not available: Apply hard direct pressure over bite using a 4 x 4 gauze pad folded in half twice. Tape in place with adhesive tape.

6. Soak gauze pad in Betadine(tm) solution if available ( if victim is not allergic to iodines).

7. Strap gauze pad tightly in place with adhesive tape.

8. Overwrap dressing above and below bite area with ACE or crepe bandage, but not too tight. No tighter than you would use for a sprain. Make sure pulses are present.

9. Wrap ACE (elastic) bandage as tight as one would for a sprain. Not too tight.

10. Check for pulses above and below elastic wrap; if absent it is too tight. Unpin and loosen.

11. Immobilize bitten extremity, use splinting if available.

12. If possible, try and keep bitten extremity at heart level or in a gravity-neutral position. Raising it above heart level can cause antivenom to travel into the body. Holding it down, below heart level can increase swelling.

13. Go to nearest hospital or medical facility as soon as possible

14. Try and identify, kill and bring (ONLY if safe to do so) offending snake. This is the least important thing you should do. Visual identification/description usually suffices, especially in the U.S.

15. Bites to face, torso or buttocks are more of a problem. Disinfect. Prep (shave hair) area with razor provided in extractor kit. Use extractor device until there is no further drainage possible and then apply pressure dressing with gauze pad and tape. ACE/crepe bandaging cannot be applied to such bites. A pressure dressing made of a gauze pad may help if a Sawyer Extractor is not available.

16. Antivenom is the only and best treatment for snakebite and you must get as much as is necessary as soon as possible. Antivenom administration should not be delayed. Up to 20 vials may be needed to neutralize the effects of rattlesnake and other crotalid venoms in North America. Children may need more than this as envenomation is apt to be much more serious in a small person compared to a larger one.