Tourniquets are contraindicated because they obstruct arterial flow and cause ischemia. Constriction bands may be of some use, especially when immediate medical care is not available. A constriction band is an elastic bandage or Penrose drain, rope, or piece of clothing wrapped circumferentially above the bite, applied with tension that restricts superficial venous and lymphatic flow while maintaining distal pulses and capillary fill. The band should be snug but loose enough to easily slide a finger underneath. In theory, a constriction band retards venom absorption. This should increase local tissue injury but reduce the severity of systemic effects. Anecdotal human reports and animal studies suggest that constriction band use delays venom absorption without causing increased swelling. 4 Additional controlled studies are needed to better define the clinical indications for constriction band use.
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