Now that warmer weather has arrived, many of us are beginning to venture out chasing turkeys and fish. But unlike turkeys and fish, almost everything surrounding a snakebite is controversial. I was told by Dr. Bill McKell of Ocean Springs, Mississippi, that "a sober person, properly clothed, behaving sensibly, is almost never bitten." I would presume that many of the snakebite victims each year in the U.S. would refute this.

Below, is the advice of Dr. McKell regarding what we should and should not do for a snakebite victim in the field.

1. Make sure the victim is away from the snake and out of danger of additional bites. Identify the snake.

2. Arrange for transportation to a hospital Emergency Room as soon as possible. Keep the victim calm and still. Do not give him or her alcohol, for it dilates blood vessels and enhances the spread of venom. If possible, have them lie flat with the bitten limb at the same level with the heart. Remove rings and other constricting jewelry (just don't get caught!).

3. "Tourniquets" are out. It is, however, almost universally recommended that one apply a large "constricting band" at a level between the bite site and the heart. Taking care not to constrict arterial blood flow, this band should allow your little finger to slip under it. Don't remove the band until antivenin is administered or decided against, however you might need to slide the band proximally in advance of the swelling.

4. Incision and suction are no longer recommended.

5. Ice and electric shock have been shown to cause further tissue damage, so don't use them.

Though this covers pre-hospital assistance, Dr. McKell advises us on two other controversial treatment modalities.

6. Prophylactic antibiotics are frequently given, but he has never seen convincing data proving their benefit. If tetanus immunization isn't current, this should be rectified.

7. The only antivenin approved by the Food and Drug Administration is associated with 10 to 25 percent rate of immediate allergic reactions and an almost universal experience of delayed allergic reactions. For this reason, the routine use of antivenin for all pit viper bites is not recommended; however, each case should be individually assessed.

Dr. McKell advises that all snakebite victims should be immediately taken for medical evaluation. If the patient is within an hour or so from an Emergency Room, first aid measures such as the constricting band may be omitted.