Snake bites

Background

• In the United States, snake bites can be organized into Crotaline (Pit Vipers) and Elapidae (Coral Snakes)
• Crotalidae family also includes rattlesnakes, Sistrurus and Agkistrodon species (water moccasins and copperheads).
• Risk Factors: "The 'T's" Testosterone, Tequila, Tshirt, Tattoos, Toothless, Teasing, Trailer park, Truck

Clinical Features

• Local injury - punctures marks from fangs not always visible, erythema, and edema
• Nausea/vomiting

Differential Diagnosis

Envenomations, bites and stings

• Hymenoptera stings (bees, wasps, ants)
• Mammalian bites
  • Closed fist infection (Fight bite)
  • Dog bite
• Marine toxins and envenomations
  • Toxins (ciguatera, neurotoxic shellfish poisoning, paralytic shellfish poisoning, scombroid, tetrodotoxin
  • Stingers (stingray injury)
  • Venomous fish (catfish, zebrafish, scorpion fish, stonefish, cone shells, lionfish, sea urchins)
  • Nematocysts (coral reef, fire coral, box jellyfish, sea wasp, portuguese man-of-war, sea anemones)
  • Phylum porifera (sponges)
  • Bites (alligator/crocodile, octopus, shark)
• Scorpion envenomation
• Reptile envenomation
  • Snake bites
    • Crotaline (Pit Vipers)
    • Elapidae (Coral Snakes)
  • Lizard bites
• Spider bites
  • Black widow
  • Brown recluse
  • Tarantula
  • Funnel-web spider bite
  • Armed spider bite

Coral snake

Rattlesnake

Diagnosis

• Clinical Diagnosis

Treatment

• Treatment mainly depends upon the presence of an envenomation
• Always provide supportive care and treat local effects of any wounds
• 8Irrigation of the wound
• Debridement and removal of devitalized tissue may be necessary for severe bites
• Snake specific treatments depend upon Coral snake or Pit viper envenomations

See Also

• Crotaline (Pit Vipers)
• Elapidae (Coral Snakes)