snakes Flashcards
two types of venomous snakes
crotalids (pit vipers)
elapidae (coral snakes)
Crotalids include?
everything but coral snakes (water moccasins, cottonmouths, rattlesnakes)
Difference between venom of crotalids versus elapidae?
crotalids are more hemotoxicity and elapidae are more neurotoxic
What do pit vipers look like?
Have triangular head as opposed to circular, have heat sensing pit, have single row of ventral scales as opposed to double
Pressure immobilization?
Controversial, thought maybe to be beneficial in neurotoxic envenomenation (more common in Australia), but can delay transport time and likely risk outweighs benefit in crotalid bites
Is compartment syndrome common in snakebites?
No, it is more common for third spacing to occur leading to subcutaneous hypertension, but compartment syndrome is rare and would need to be confirmed by direct measurement, and even so, fasciotomy is not always considered first line because muscle necrosis is caused directly by venom
Hematologic consequences of crotalid venom?
fibrinolysis and thrombocytopenia from platelet consumption at site of clot. No effect on other clotting factors.
Most important labs for envenomation?
CBC, fibrinogen, PT
What are the indications for Crofab
more than minimal swelling, rapidly progressing swelling or swelling that crosses a joint, elevated PT, signs of neurological or systemic toxicity, late coagulopathy
how much crofab do you give?
4-6 vials bolus or 8-12 if sick, if symptoms become controlled, then 2 every 6 hours, if not continue 4-6 every 6 hours until symptoms controlled
When should coral snake bites be treated?
3-5 vials at the first sign of systemic toxicity
What allergy precludes possible allergic reaction to crofab?
papain (papaya/pineapple)
