How Should Native Crotalid Envenomation Be Managed in the Emergency Department?
Title
How Should Native Crotalid Envenomation Be Managed in the Emergency Department?
Creator
Greene S; Cheng D; Vilke GM; Winkler G
Publisher
The Journal Of Emergency Medicine
Date
2021
2021-02-20
Description
BACKGROUND: Pit vipers, also known as crotalids, are a group of snakes including rattlesnakes, copperheads, and cottonmouths (water moccasins). Crotalids have a broad geographic distribution across the United States, and bites from these snakes can carry significant morbidity. Their envenomations are characterized by local tissue effects, hematologic effects, and systemic effects. Envenomations are generally treated with 1 of 2 antivenoms available in the United States. OBJECTIVE: We developed a series of clinical questions to assist and guide the emergency physician in the acute management of a patient envenomated by a crotalid. METHODS: We conducted a PubMed literature review from January 1970 to May 2020 in English for articles with the keywords "bite" and "crotalidae." RESULTS: Our literature search resulted in 177 articles. A total of 33 articles met criteria for rigorous review and citation in the development of these consensus guidelines. CONCLUSIONS: Patients should be initially evaluated, stabilized, and assessed for local effects, hematologic effects, and systemic toxicity suggestive of envenomation. Antivenom should be given if toxic effects are present. Surgical intervention including debridement and fasciotomy should be avoided. Prophylactic antibiotics are not necessary.
Subject
toxicology; ANAVIP; copperheads; cottonmouths; CroFab; crotalid; envenomation; rattlesnakes; snakebite
Identifier
Format
journalArticle
URL Address
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Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
ISSN
0736-4679
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
Update Year & Number
March 2021 List
Affiliated Hospital
Cleveland Clinic Akron General Hospital
Citation
Greene S; Cheng D; Vilke GM; Winkler G, “How Should Native Crotalid Envenomation Be Managed in the Emergency Department?,” NEOMED Bibliography Database, accessed April 24, 2024, https://neomed.omeka.net/items/show/11588.