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<< Bites and Stings – Snakes, Spiders, and Scorpions in the United States

Snakes: Diagnostic Studies

In cases of crotaline envenomation, baseline studies should be obtained upon the patient's arrival to the emergency department. A complete blood count with platelets, PT, PTT, INR, and fibrinogen, electrolytes with glucose, BUN, creatinine, and urinalysis should all be obtained and repeated in four to eight hours. The creatine phosphokinase should be checked in cases of extensive myonecrosis or fasciculations. It is important to monitor for recurrence phenomena and rebound coagulopathy following treatment with crotaline Fab antivenom (CroFab®). This phenomenon may be due to the rapid clearance of the Fab fragments compared to retained venom at the envenomation site; therefore, recommendations have been made to closely monitor patients after CroFab® therapy.20,28,35

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Last Modified: 08/17/2017
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