There is a snakebite kit in a lot of first aid bags. The little plastic case with the suction cups.

Take it out and throw it away.

The extractors have been tested. They remove a negligible fraction of the venom — well under one percent — while pulling additional damage into tissue that is already being digested. The venom goes in deep and intramuscular. You are not sucking it back out through a fang hole with a plastic syringe. What you are doing is bruising and blistering a limb that has enough problems.

The Red Cross, the CDC, the American College of Medical Toxicology and the Wilderness Medical Society all say the same thing on this. So does every emergency physician I can find who has written about it.

I had the suction device in my own book. It is out now.

The constricting band went with it. Same reasoning, worse consequences. A band or a tourniquet above a pit viper bite traps venom that destroys tissue where it sits. You concentrate the damage instead of diluting it. People have lost limbs to a well-meant bandana.

So what do you actually do.

Get him to a hospital that stocks antivenom. That is the treatment. Everything else you do is managing the clock.

Keep him calm and still. A racing heart moves venom faster. Get the rings, the watch, the bracelet off before the limb swells and they become tourniquets you can’t remove. Splint the limb loosely and keep it at about heart level — the old advice to hold it below the heart has been dropped.

Then take a pen and mark the leading edge of the swelling. Write the time next to it. Do it again every fifteen minutes.

That is the single most useful thing you can do, and almost nobody does it. The hospital cannot reconstruct that progression after the fact, and it tells them how fast this is moving and how much antivenom to give. A ballpoint pen is a better piece of snakebite equipment than anything in the kit you just threw away.

Do not cut the bite. Do not apply ice. Do not give him whiskey.

And do not go after the snake. A photograph from a safe distance is plenty, and a severed head can still bite by reflex for the better part of an hour. Emergency rooms have treated the second bite more than once, and the second bite is always the guy who was trying to help.

A note on the odds, because the fear is out of proportion to the risk. Somewhere around seven to eight thousand people are bitten by venomous snakes in the United States in a year. About five of them die. Roughly one bite in ten is dry, with no venom injected at all. This is a serious medical emergency and it is very rarely a fatal one, provided nobody does something clever on the way to the hospital.

Rattlers never really concerned me. We used to eat them. Where snakes get dangerous is in the water, and hitting a nest of moccasins is a different kind of afternoon.

The corrected snakebite protocol is in the updated The Green Beret Preparation and Survival Guide.

The best snakebite first aid is usually less than you think you should be doing.

The Green Beret Preparation and Survival Guide is here: https://amzn.to/3BYEq5E

To read what a survival scenario looks like and how to respond, my fiction Green Beret Survival Series is here: https://amzn.to/4nEf1XB