Podcast 682: Snake Bites

<p><strong>Contributor:  Gretchen Hinson, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Pit vipers include cottonmouths, rattlesnakes, and copperheads</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">All have folding long fangs, triangular face, and elliptical pupils</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">About 5,000 snakebites per year reported to Poison Control</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Initially develop a local reaction (swelling, bruising, pain, bullae)</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Complications can include </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">25% of snake bites result in no envenomation (dry bites)</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">20% of bites have serious side-effects, which can include hematologic, cardiovascular, neurologic and, muscular abnormalities, or even anaphylaxis to the envenomation itself</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Minor symptoms should be observed for 12-24 hours</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Moderate to severe symptoms are typically treated with antivenom </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">CroFab and other antivenoms are expensive, with costs upwards of $3200 per vial wholesale, though newer agents are cheaper</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Treat with 4-6 vials of CroFab initially with moderate symptoms and subsequent redosing with </span></li> </ul> <p><strong>References</strong>