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

Snakes: Special Circumstances

First Aid For Snakebites

Availability of prompt medical care is usually not an issue for victims of snake envenomation. However, in cases of snakebites occurring in isolated areas, first aid treatment can help prolong survival. If a snakebite victim is unable to get help within 30 minutes, a loose bandage wrapped two to four inches above the bite may slow the venom's lymphatic spread. The bandage should be loose enough for a finger to slip between the bandage and the extremity. Another possibility is using a commercially available suction device to attempt to remove any venom that is pooled underneath the subcutaneous tissue. Unfortunately, studies have not proven that these extractors are effective in treating snake envenomations in humans.42

A possible option for treatment of crotaline snakebites in isolated areas is to carry unconstituted lyophilized CroFab®. CroFab® is heat and motion stable and can be easily transported. It could possibly be reconstituted in the field and administered to a snakebite victim.

Pregnancy

Crotaline envenomations have been reported to cause sequelae to both mother and fetus. In one case review, crotaline envenomations caused a 43% rate of fetal demise and a 10% maternal mortality rate.43 In another series of pregnant women suffering snake envenomation, the abortion rate was 30% compared to a baseline 7.7% abortion rate in the population. The authors of this series suggest a significantly increased risk of poor fetal outcome if envenomated earlier in the pregnancy.44

The use of CroFab® in pregnancy has not been evaluated because pregnant patients were excluded from the pre-marketing studies. There have been case reports documenting treatment with CroFab® in the third trimester of pregnancy, but no definite recommendations can be made from these cases.22

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Last Modified: 06/27/2017
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