Snake Bite - Copperhead - Water Moccasin - Rattlesnake - Cottonmouth - Coral Snake - Trauma CME | Digest
0
TOC Will Appear Here

Emergency Department Management of North American Snake Envenomations

9,354 views
Below is a free preview. Log in or subscribe for full access. Or, get a free sample article Emergency Department Management of Abnormal Uterine Bleeding in the Nonpregnant Patient:
Please provide a valid email address.

Points and Pearls Excerpt

  • Pit vipers—rattlesnakes, copperheads, and water moccasins/cottonmouths—produce a predominantly hemotoxic venom. Both local and systemic effects can occur. Systemic effects include tachycardia, tachypnea, hypotension, nausea, vomiting, weakness, and diaphoresis.
  • Patients with snakebite should be treated with supportive care, pain control, and specific antivenom, when indicated.
  • In general, venomous pit vipers have a triangular or spade-like head, elliptical pupils, and hollow, retractable fangs.
  • Usually, venomous coral snakes have adjacent red and yellow bands; if there is a black band between the red and yellow, the snake is usually nonpoisonous.
  • Coral snakes have teeth, not fangs, and tend to “chew,” rather than bite.

Most Important References

  • Lavonas EJ, Ruha AM, Banner W, et al. Unified treatment algorithm for the management of Crotaline snakebite in the United States: results of an evidence-informed consensus workshop. BMC Emerg Med. 2011;11:2-227X-11-2. (Consensus panel) DOI: https://doi.org/10.1186/1471-227X-11-2
  • Bush SP, Ruha AM, Seifert SA, et al. Comparison of F(ab’)2 versus Fab antivenom for pit viper envenomation: a prospective, blinded, multicenter, randomized clinical trial. Clin Toxicol (Phila). 2015;53(1):37-45. (Randomized controlled trial; 121 patients) DOI: https://doi.org/10.3109/15563650.2014.974263
  • American College of Medical Toxicology, American Academy of Clinical Toxicology, American Association of Poison Control Centers, European Association of Poison Control Centres and Clinical Toxicologists, International Society on Toxicology, Asia Pacific Association of Medical Toxicology. Pressure immobilization after North American Crotalinae snake envenomation. Clin Toxicol (Phila). 2011;49(10):881-882. (Position statement) DOI: https://doi.org/10.1007/s13181-011-0174-2
  • Wood A, Schauben J, Thundiyil J, et al. Review of eastern coral snake (Micrurus fulvius fulvius) exposures managed by the Florida Poison Information Center Network: 1998- 2010. Clin Toxicol (Phila). 2013;51(8):783-788. (Retrospective; 387 patients) DOI: https://doi.org/10.3109/15563650.2013.828841
  • Cumpston KL. Is there a role for fasciotomy in Crotalinae envenomations in North America? Clin Toxicol (Phila). 2011;49(5):351-365. (Review) DOI: https://doi.org/10.3109/15563650.2011.597032
  • Walker JP, Morrison RL. Current management of copperhead snakebite. J Am Coll Surg. 2011;212(4):470-474. (Retrospective; 142 patients) DOI: https://doi.org/10.1016/j.jamcollsurg.2010.12.049
  • Hwang CW, Flach FE. Recurrent coagulopathy after rattlesnake bite requiring continuous intravenous dosing of antivenom. Case Rep Emerg Med. 2015;2015:719302. (Case report) DOI: http://dx.doi.org/10.1155/2015/719302
To Read The Companion Article:
To Read The Companion Article:
To Read The Companion Article:
Already purchased this course?
Log in to read.
Purchase a subscription

Price: $449/year

140+ Credits!

Money-back Guarantee
Publication Information
Authors

Sophia Sheikh, MD; Patrick Leffers, PharmD

Peer Reviewed By

Daniel J. Sessions, MD; Andy Jagoda, MD, FACEP

Publication Date

September 1, 2018

Get Permission

Content You Might Be Interested In

Terrestrial Envenomations in Pediatric Patients: Identification and Management in the Emergency Department (Trauma CME and Pharmacology CME)

Identification and Management of Marine Envenomations in Pediatric Patients

Get A Sample Issue Of Emergency Medicine Practice
Enter your email to get your copy today! Plus receive updates on EB Medicine every month.
Please provide a valid email address.