In an adult patient with a suspected hypotensive snake bite, which measure is specifically advised against?

• A. Mark area of edema or redness with a pen
• B. DO NOT apply ice packs, tourniquets or constrictive bands
• C. Remove any constrictive jewelry or clothing
• D. Normal Saline: 1L

Answer: (B)

In suspected venomous snakebite with hypotension, the aim is to limit venom spread and support circulation without causing additional tissue damage. Ice packs, tourniquets, or any constrictive bands can worsen local tissue injury and can trap venom in the limb, potentially increasing damage and delaying systemic symptoms from spreading. Ice causes vasoconstriction and tissue injury, tourniquets cut off blood flow and can lead to ischemia, and constrictive bands similarly restrict circulation, all of which are unhelpful in this scenario.

Context helps: marking the edge of edema helps monitor how swelling progresses, and removing constrictive jewelry or tight clothing is recommended because swelling can rapidly encroach on these items. In a hypotensive patient, restoring circulation with appropriate IV fluids (such as a cautious isotonic saline bolus) is part of initial management, along with monitoring and preparing antivenom if indicated.