‘If I had an hour to solve a problem and my life depended on it, I would use the first 55 minutes determining the proper question to ask, for once I knew the proper question, I could solve the problem in less than five minutes.’ —Albert Einstein


It was only a few decades ago that incision and suction were recommended snakebite first aid. However, concerns arose about injuries and infections caused when laypersons made incisions across fang marks and applied mouth suction. Meanwhile, several snakebite suction devices (eg, Cutter’s Snakebite Kit, Venom Ex) were evaluated, and it was determined that they were neither safe nor effective. So, recommendations changed, and mechanical suction without incision was advocated instead. It seemed intuitive that suction alone would probably remove venom and should not cause harm. However, when the techniques were studied rigorously, quite the opposite was discovered.

One of the most popular suction devices, the Sawyer Extractor pump (Sawyer Products, Safety Harbor, FL), operates by applying approximately 1 atm of negative pressure directly over a fang puncture wound (or wounds) without making incisions. […] Although each of these 3 studies was done independently of each other and using different methodology, they arrive at the same conclusion: the Extractor does not work, and it could make things worse.

{ Annals of Emergency Medecine | PDF }