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So You Went Out and Got Yourself Snakebitten. Now What?

One of the most common mistakes when it comes to managing snakebites is observing the patient for an insufficient amount of time. Snakebites are dynamic, and what looks insignificant at first may become much more serious over several hours. If there are no signs or symptoms, observation is still warranted for at least 8 hours. Many “dry bites” are misdiagnosed because they are discharged from the emergency department prematurely. Remember, a dry bite means there are no venom effects, which include swelling, bruising, or significant tenderness.

If these are present, it’s not a dry bite, regardless of the laboratory test results. If there is ANY evidence of envenomation, observation…

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Featured

 Management of Venomous Snake Bites in North America: Separating the Evidence from Medical Folklore

Avoid commonly used prehospital therapies which cause more harm.

Articles of Interest

Approach to Snakebite

Fortunately it is rare to have a severe envenoming as many bites will have insufficient venom injected (dry bite). However, due to the potential lethality of snakebites they should be managed with a time-critical robust approach.

Management of Snake Bite Injuries

In this article, we review the common management of snake bite injuries and envenomations for the two major snake groups in the United States.

A New Solution For Snakebites

Snakebites are common, but anti-venom can be hard to get. One doctor is trying a new solution, with help from a former rock star.

Approach and management of venomous snake bites: a guide for the primary care physician

Administration of antivenom halts the progression of local tissue effects, reduces hematologic effects, and decreases systemic effects from crotaline envenomations. Antivenom should be administered within four hours of a snake bite but can be effective for as many as 24 hours post envenomation.

Big strides are being made in the push for affordable, effective antivenoms

For city dwellers, especially those in the developed world, the idea of being bitten by a venomous snake seems outlandish. But it is a daily and very real risk for millions around the world – and that includes many people living in African countries.

Coral Snake Envenomations: Just Keep Breathing

For any patient who presents to the ED after being bitten by a coral snake, initial assessment must begin with airway, breathing, circulation, and vital sign abnormalities. Particular importance is placed on assessing respiratory and neurologic status. Envenomations of US coral snake species do not typically result in laboratory abnormalities.

Emergency treatment of a snake bite: Pearls from literature

Snake bite is a well-known occupational hazard amongst farmers, plantation workers, and other outdoor workers and results in much morbidity and mortality throughout the world. This occupational hazard is no more an issue restricted to a particular part of the world; it has become a global issue.

Envenomations: Initial Management of Common U.S. Snakebites

Most venomous snake bites in the U.S. are from Crotalinae, or pit vipers...

How the science of snake bite treatments has changed

Gone are the days when we were told to suck out a snake’s venom. So what’s the current treatment and how have treatments changed over time?

How to Save People From Snakebites

The desperate search for better antidotes that can work against many types of venom.

How to simplify the treatment of snake bites

Snake venom kills around 140,000 people a year and debilitates roughly 400,000 others. One reason for these large numbers is that every venom needs a specific antivenin to treat it. In places with rich ophidian faunas, dozens of antivenins may therefore need to be kept to hand. Even if these are available, though, they are no guarantee of success. Someone who has been bitten may not have seen the assailant, or may be an unreliable witness. Only if the snake itself has been caught or killed can medics be sure what they are dealing with. To make things worse still, administering the wrong antivenin may not merely be useless, but dangerous,

Many antidotes to snake venom do not work as well as they might

Venom varies from place to place. Antivenoms must take account of this.

The Quest to Modernize Snakebite Medicine

Snakebites kill more than 100,000 people a year world-wide, but the problem has been largely ignored. Now, scientists are working on new ways to help victims.

Tiny Nanoparticles to Treat a Huge Problem: Snakebites

Snakes kill or cripple 500,000 people a year, but antivenins are costly and rare in poor countries. Now scientists are testing injectable nanoparticles that neutralize venom.

Resources

SAEM

Antivenin may require repeat doses due to recurrence phenomenon. Antivenom can cause hypersensitivity reactions and may lead to anaphylaxis.

StatPearls

This activity discusses the evaluation and management of snake envenomation and the associated toxidromes. It highlights the importance of effective first aid, patient monitoring, and targeted treatment throughout the disease process by the interprofessional team.