Management of a snake bite in the field

We present a case of an 18-year-old British soldier who was bitten by an unidentified snake whilst stationed on the Iran/Iraq border. He was evacuated to the closest Role 2+ medical facility. Within 2 days he had developed bruising and a haematoma at the bite site. An improvised measure of clotting status, the bleeding time, was employed, showing that his blood was severely anticoagulated. He was transferred to the Field Hospital where coagulation screen revealed a DIC picture. He required 5 units of cryoprecipitate and 2 doses of antivenom. This case report demonstrates the need for prompt evacuation to a Role 3 facility in such cases, whether symptomatic or not.