Summary

A 29-year-old woman presented to a community hospital in Sierra Leone 2 hours after being bitten by an unknown snake. On arrival, she was agitated though alert, however deteriorated into respiratory arrest. There was no local availability of antivenom. The patient remained in respiratory arrest undergoing best supportive care in a low-resource setting for 2 hours 55 minutes before returning to spontaneous ventilation. She went on to make a full neurological recovery. Though spontaneous recovery following snakebite envenoming is rare, this case showcases that good communication and basic manoeuvres can have a hugely positive impact on patient outcome. Alongside this, it highlights the need for staff and community engagement and implementation of local protocols in order to improve confidence and achieve consistent practice.