global snake envenomation management

Question 1

There are 3 major clinical syndromes of snakebite envenomation worldwide, what are they?

Answer 1

neurotoxic, hemotoxic, cytotoxic

Question 2

What are the major signs and symptoms of a neurotoxic snakebite?

Answer 2

bilateral ptosis, descending paralysis, dyspnea/altered mental status

Question 3

What are the major signs and symptoms of a hemotoxic snakebite?

Answer 3

coagulopathy, local bleeding, systemic bleeding

Question 4

What are the major signs and symptoms of a cytotoxic snakebite?

Answer 4

severe pain, progressive edema, tissue destruction

Question 5

T/F Identifying the snake species will not change your patient care

Answer 5

true

Question 6

T/F snake bite victims should be aggressively treated with antivenin regardless of if they developed signs of symptoms

Answer 6

true

Question 7

what is the preferred route for snake antivenin administration

Answer 7

IV

Question 8

T/F Antivenom dosage is not weight-based and there is no difference in dosing between adults and children.

Answer 8

true

Question 9

T/F Overdosing antivenom is not a concern during the active treatment phase, and the worst-case scenario is an allergic reaction.

Answer 9

true

Question 10

T/F the evacuation of a patient with snakebite envenomation takes precedence over the administration of the appropriate antivenom

Answer 10

false, antivenom as soon as possibel

Question 11

Observe and monitor the patient closely at the bedside for a minimum of_______ after each dose of antivenom has been given.

Answer 11

one hour

Question 12

T/F compartment syndrome is common in snakebites. patients should receive a fasciotomy in conjunction with antivenom in most cases

Answer 12

false

Question 13

T/B Routine administration of antibiotics should not be given to patients with snakebites unless signs and symptoms of an infection are present. Direct infections are rare from most snakebites when prompt, appropriate treatment is given.

Answer 13

true

Question 14

Continuous clinical monitoring for effectiveness of antivenom includes

Answer 14

hourly checks of vital signs, urine output, and detailed assessment for new or worsening signs of neurotoxic, hemotoxic, or cytotoxic envenomation.

Question 15

Patients should be held for at least 24 hours after resolution of all signs and symptoms, and the following steps should be completed prior to discharge:

Answer 15

a. Repeat blood tests before releasing the patient to ensure resolution of coagulopathy.
b. Administer a booster dose of tetanus toxoid if needed.
c. Patients should be instructed to return if any new or worrying signs or symptoms develop

Question 16

___________is the only prophylactic treatment (pretreatment) that has been shown to effectively reduce the incidence of early adverse reactions in snakebite patients

Answer 16

Epinephrine

Question 17

T/F Serum sickness may be uncomfortable, but it is not dangerous.

Answer 17

true

Question 18

What interventions are not appropriate when treating a snakebite?

Answer 18

do not suck or cut the bite, don’t use suction devices, don’t use tourniquets, do not administer test doses of antivenom (just use it all), don’t administer antihistamines or steroids

Question 19

WHO category __ snakes are Defined as “highly venomous snakes which are common or widespread and cause numerous snakebites, resulting in high levels of morbidity, disability or mortality.”

Answer 19

1

Question 20

WHO category __ snakes are Defined as “highly venomous snakes capable of causing morbidity, disability or death, for which exact epidemiological or clinical data may be lacking; and/or which are less frequently implicated (due to their activity cycles, behavior, habitat preferences or occurrence in areas remote to large human populations).”

Answer 20

2