Snake Bites in Nepal — What to Do in the First 30 Minutes
Nepal has ~90 snake species; about 20 are venomous. The dangerous ones are mostly in the Terai (cobras, kraits, vipers), but pit vipers live on trekking trails too. What you do in the first 30 minutes determines whether the outcome is a scare or a tragedy. The wrong first aid kills people.
Venomous Snakes in Nepal
| Snake | Habitat | Venom Type | Danger |
|---|---|---|---|
| Cobra (Naja) | Terai lowlands, Kathmandu valley edges | Neurotoxic — paralysis, respiratory failure | High — responsible for most serious bites |
| Russell's Viper | Terai, grasslands, rice paddies | Hemotoxic — bleeding, organ damage, DIC | High — extremely dangerous |
| Common Krait | Terai, nocturnal — bites while sleeping | Neurotoxic — painless bite, delayed paralysis | Very high — most dangerous: silent onset |
| Pit Vipers (Green Pit) | Hills/mountain forests, bushes | Hemotoxic — swelling, bleeding | Moderate — painful but rarely fatal |
DO — Correct First Aid
- Stay calm — panic raises heart rate and spreads venom faster
- Immobilize the limb — splint it like a fracture; no walking if possible
- Keep the bite below heart level — slows venom circulation
- Remove jewelry/rings — swelling comes fast
- Note the snake's appearance — size, color, pattern (photo if safe, don't chase it)
- Get to a hospital with antivenom — not a teahouse, not a clinic — an actual hospital
DON'T — What Kills People
- Cut the wound or suck out venom — spreads infection and doesn't help
- Apply a tourniquet — cuts off blood flow, causes tissue death
- Apply ice or heat — worsens local tissue damage
- Drink alcohol or coffee — accelerates venom spread
- Walk or run for help — every step pumps venom; send someone else
- Take aspirin — increases bleeding risk with hemotoxic venom
Where to Get Antivenom
Antivenom is stocked at major hospitals: Bir Hospital, Patan Hospital, Nepal Medical College, and Chitwan Medical College in the Terai. We stabilize and refer immediately — snake bites need hospital-level care, not clinic treatment. Our emergency page has directions.
The Lowland Reality
Nepal's dangerous snakes are lowland animals — the Terai plains, the valleys, the warm forests where cobras and vipers hunt. The trekking routes above 2,500m are essentially free of venomous snakes (too cold). The risk concentrates in the places trekkers spend less time: the lowlands, the jungle areas, the warm monsoon-season trails below the mountains.
Snake safety protocol
- Stay on open trails — snakes avoid exposed areas
- Watch where you step — basking snakes on warm rocks
- Headlamp at night — nocturnal hunters in warm months
- Never reach into vegetation or rock piles — the hidden snake
- If bitten: immobilize, keep below heart, get antivenom — do not cut or suck
The Antivenom Imperative
The snake bite is a race against time — venom spreads, antivenom is the only treatment, and the hours to medical care determine the outcome. The remote lowland trail with no antivenom access is the worst-case scenario; the bite in Kathmandu or near a town is manageable. The preparation is knowing where you are relative to the antivenom that may save you.
The Species in Nepal
Nepal has venomous snakes — the cobra, the krait, the Russell's viper, the green pit vipers, and the saw-scaled viper. Most are not aggressive; the snake that is disturbed or threatened may strike. The awareness of the presence is the avoidance that prevents the encounter.
The Bite Protocol
Snake bite first aid: keep the limb still (immobilize — the movement spreads the venom), remove the tight clothing/jewelry (before the swelling), do not cut or suck the wound (the outdated first aid that is harmful), and get to the medical care urgently. The antivenom that is available in Kathmandu; the time to the treatment is the factor.
The Nepal Species
Nepal's venomous snakes: the cobras, the kraits, the vipers, and the green pit vipers. The terai (the lowlands) has the higher diversity; the mountain areas have fewer species. For the snake bite, the identification is helpful for the antivenom selection but not required — treat all as potentially venomous.
The Bite Response
Snake bite first aid: immobilize the limb (the splint that reduces the spread), remove the constricting items (the rings, the watches), no cutting/sucking/ tourniquet (the harmful traditional remedies), and the urgent evacuation to the medical facility for the antivenom.
The Antivenom
Snake antivenom — the polyvalent antivenom that covers the cobra, the krait, the viper, and the pit viper. For the snake bite, the antivenom that is administered as soon as possible.
The Symptoms
Snake bite symptoms: the local (the pain, the swelling, the discoloration) or the systemic (the neurological, the bleeding, the cardiovascular effects). For the snake bite with the systemic symptoms, the urgency that is elevated.
The Antivenom
Snake antivenom — the polyvalent that covers the common Nepal species. For the envenomation, the antivenom that is the treatment.
The First Aid
Snake bite first aid — the immobilization (the splint that limits the movement), the no tourniquet (the tourniquet that damages), the no cutting or sucking, and the rapid evacuation.
The Antivenom
Snake antivenom — the species-specific (the polyvalent that covers). For the envenomation, the antivenom that is the treatment.
The First Aid
Snake bite first aid — the immobilization (the limb that is splinted), the no cutting (the harm that is caused), and the rapid transport.
The Antivenom Cost
Antivenom cost — the ~$50-200+ (the multiple vial that may be needed) + the ICU stay. For the envenomation, the significant cost that is the insurance-covered.
The Hospitalization
Snakebite hospitalization — the observation + the monitoring (~$100-300/day). For the severe, the admission that is required.
The Antivenom Cost
Antivenom cost — the ~$100-500+ (the hospital-administered that is expensive). For the envenomation, the urgent that is priced.
Clinic vs. Hospital
Snakebite setting — the clinic assessment (the ~$40 that rules out) vs the hospital admission (the envenomed that needs). For the bite, the evaluated that directs.
The Antivenom Cost
Antivenom — the ~$100-500+ (the vial-dependent that is the treatment). For the envenomated, the given that is the hospital.
The Bite Care
Snake-bite care — the ~$100-1,000 (the monitored that is the course). For the dry-bite, the watched that is the cheaper.
Are there dangerous snakes in Nepal?
Yes — cobras, kraits, vipers, and pit vipers exist in Nepal, primarily at lower elevations (Terai, valleys). Trekking routes above 2,500m are essentially snake-free (too cold). The risk is in lowland areas: Chitwan, the Terai plains, and Kathmandu valley edges where humans and snakes overlap.
What should I do if bitten?
Immobilize the limb (splint if possible), remove constricting items (rings, watches), keep the bite below heart level, and get to medical care immediately — antivenom is needed for venomous bites. Do NOT: cut the wound, suck the venom, apply a tourniquet, or try to catch the snake. Time is the critical variable.
How do I avoid snake encounters?
Stay on trails (they avoid open paths), watch where you step (they bask on warm rocks), use a headlamp at night (they hunt at night in warm months), do not reach into vegetation or rock piles, and shake out boots and gear before use (they shelter in dark spaces). The encounter you avoid is the bite you do not get.
What about snakes in Kathmandu?
Rare but present — green areas, the edges of the city, monsoon season increases activity. The urban snake encounter is uncommon; the rural and lowland encounter is the risk. If you see one, do not approach — most bites happen when people try to kill or move snakes.
What are the venomous species to know?
Spectacled cobra (monsoon, lowlands), common krait (nocturnal, Terai), Russell's viper (agricultural areas), and Himalayan pit vipers. Identification matters for antivenom selection — photograph the snake if possible without approaching it. Most bites are from vipers or cobras; the treatment is specific to the species.
