Podcast # 343: Snake Bites

Educational Pearls:   Snake bites commonly occur between April and October. Rattlesnake bites are the most common. Venom contains proteins/enzymes that cause local inflammation, coagulopathy, and systemic effects (hypotension, angioedema, renal failure, etc.) along with neurotoxins may cause fasciculations, ptosis, drooling, or hyporeflexia. Management: Mark site for swelling. Monitor progression. Elevate and immobilize injured limb and treat pain. Check basic labs including coagulation studies, and update tetanus. Antidote is CroFab and use if patient has systemic symptoms.  Anaphylaxis is a known complication of CroFab Avoid: ice, tourniquets, and incision and drainage.   References Hifumi T et. al.. Venomous snake bites: clinical diagnosis and treatment. J Intensive Care. 2015 Apr 1;3(1):16. doi: 10.1186/s40560-015-0081-8. Warrell DA. Snake bite. Lancet. 2010. 375(9708):77-88. doi: 10.1016/S0140-6736(09)61754-2. Warrell DA. Envenoming and injuries by venomous and nonvenomous reptiles worldwide. In: Wilderness Medicine, 6th Edition, Auerbach PS (Ed), Elsevier Mosby, Philadelphia 2012. p.1040.