Emergency Medical Minute

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, ca