Emergency Management of Poisonous Snakebites

In brief

Though 42 snake species in the United States can inflict a poisonous bite, management is the same for 99% of bites because 99% of bites are inflicted by pit vipers. First aid instructions stressing rapid transit to a hospital apply to all bites. Surgical intervention has no place in acute snakebite treatment. Antivenin therapy is appropriate except in cases of mild pit viper envenomation. Pit viper antivenin is the right choice for any pit viper envenomation, and the patient history will guide the choice of coral snake antivenin. For any antivenin administration, care must be taken to prevent allergic reactions. Basic supportive care involves pain control, correcting metabolic and hematologic complications, keeping the patient comfortable, and preventing serum sickness.

Additional information

Notes on contributors

J. Brad Lichtenhan

Dr Lichtenhan is a family physician in practice at Associates in Family Care in Paola, Kansas. As a herpetology hobbyist, he breeds snakes and frequently presents lectures and live snake and other reptile demonstrations before medical, school, and civic groups.