Podcast 837: Snakebites

<p><strong>Contributor: Meghan Hurley, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Venomous snakes in the United States include species from the family Elapidae and subfamily Crotalinae</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">In prehospital setting, elevate the bitten extremity and transport to hospital immediately</span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Do not attempt interventions with the bite site </span></li> </ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Monitor for progression of swelling past any joint line, systemic symptoms or lab abnormalities for 8-12 hours </span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Symptoms may present up to hours after bite  </span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Crotalinae venom has heme toxicity and may present with lab pattern of DIC </span></li> </ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Treatment for all symptoms is antivenom</span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">If symptoms persist or progress, continue to treat with antivenom </span></li> </ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Compartment syndrome is rare with snake bites</span></li> </ul> <p> </p> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Ruha AM, Kleinschmidt KC, Greene S, et al. The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry.</span> <em><span style="font-weight: 400;">J Med Toxicol</span></em><span style="font-weight: 400;">. 2017;13(4):309-320. doi:10.1007/s13181-017-0633-5</span></p> <p> </p> <p><span style="font-weight: 400;">Aziz H, Rhee P, Pandit V, Tang