1. If the patient is being medically evacuated from the field or between roles of care, confirm that the receiving facility has an adequate supply of the appropriate regionally specific antivenoms listed in this CPG to ensure treatment coverage against local species of concern. Alternatively, have the antivenom transported to the patient.
NOTE: Evacuation is not an alternative to antivenom administration. A patient whose snakebite warrants evacuation will require antivenom. The earlier it is given the greater the chance of full recovery without permanent disability. DO NOT delay administration of antivenom in the field to a patient with an envenomation.
2. If clinical evidence of envenomation is present and treatment is occurring in a hospital setting, always admit to a bed with continuous vital sign monitoring if available. If treating in the field, continuously monitor patient trends for signs of progression, improvement, or deterioration.
3. If no initial clinical evidence of envenomation, follow the Asymptomatic Algorithm for assessment intervals and disposition guidance.