Contributor: Meghan Hurley, MD

Educational Pearls:

• Venomous snakes in the United States include species from the family Elapidae and subfamily Crotalinae
• In prehospital setting, elevate the bitten extremity and transport to hospital immediately
• Do not attempt interventions with the bite site
• Monitor for progression of swelling past any joint line, systemic symptoms or lab abnormalities for 8-12 hours
• Symptoms may present up to hours after bite
• Crotalinae venom has heme toxicity and may present with lab pattern of DIC
• Treatment for all symptoms is antivenom
• If symptoms persist or progress, continue to treat with antivenom
• Compartment syndrome is rare with snake bites

References

Ruha AM, Kleinschmidt KC, Greene S, et al. The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry. J Med Toxicol. 2017;13(4):309-320. doi:10.1007/s13181-017-0633-5

Aziz H, Rhee P, Pandit V, Tang A, Gries L, Joseph B. The current concepts in management of animal (dog, cat, snake, scorpion) and human bite wounds. J Trauma Acute Care Surg. 2015;78(3):641-648. doi:10.1097/TA.0000000000000531

Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD, & Erik Verzemnieks, MD

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