Early management of bites by the eastern diamondback rattlesnake (Crotalus adamanteus): studies in monkeys (Macaca fascicularis).

Monkeys were injected subcutaneously with 6 mg of Crotalus adamanteus venom and a solid phase radioimmunoassay was used to measure levels of venom in plasma and urine. When no attempt was made to retard venom movement from the site of injection, plasma levels as high as 1,300 ng/ml occurred within 15 min of injection and progressive swelling developed in the injected limb. When first aid was employed (firm pressure to the injection site and immobilization of limb with a splint), plasma levels remained very low until cessation of first aid. No swelling of the injected limb occurred while the first aid measures were in position, and animals which received first aid an antivenom fared much better than did those which received antivenom alone. The best result was obtained when antivenom was infused prior to removal of the pressure bandages and splint. This first aid procedure is effective in delaying venom movement, and its simplicity and safety suggest it should be considered for use in cases of human envenoming by C. adamanteus.