The first several hours after the bite are most critical. Poisonous bites cause local signs (oedema, hemorrhage, ecchymosis necrosis and systemic signs mainly involving nervous and cardiac system). First aid measures should be applied as quickly as possible.
Reassure and calm the victim. Put the victim in lying position and restrain from unncessary movements. Clean wound with water and soap, then dry it with sterilized gauze.
o Observe pulse and breathing, if breathing stop, give mouth to mouth breathing. If pulse stops apply CPR.o Keep the affected limb below heart level.o Immobilize the limb and splint.o You may apply a bandage above level of the bite adequately tight to permit passage of a finger underneath
Make sure, you can feel the peripheral pulse below level of bandage. If you are more than 20 minutes away from medical facility, apply a bandage as before, then make small longitudinal incision 1 cm long and 2 mm deep and suck the venum with suction cup or with your mouth. (Avoid suction by mouth if you have mouth sores or wound). Transfer patient to the nearest hospital as fast as possible and on the way continue to reassure observe and maintain airway and breathing