Snakebite (cont.)

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Medical Author:

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Snakebite Medical Treatment

The doctor treats life-threatening conditions first. A victim with difficulty breathing may need a tube placed in his or her throat and a ventilator machine used to help with breathing. People who are in shock may require intravenous fluids and possibly other medicines to maintain blood flow to vital organs.

If indicated and available for the specific type of snake, the doctor will consider giving antivenin to victims with significant symptoms. This therapy can be life saving or limb saving. Giving an antivenin is a difficult decision as the antivenin can have significant side effects including causing allergic reactions or even anaphylactic shock, a life-threatening type of shock requiring immediate medical treatment with epinephrine and other medications. However, antivenin treatment is still the treatment of choice but the physician and patient should be aware of the risks.
Antivenin can also cause serum sickness within 5-10 days of therapy. Serum sickness causes fevers, joint aches, itching, swollen lymph nodes, and fatigue, but it is not life-threatening.
Even victims without significant symptoms need to be monitored for several hours, and some people need to be admitted to the hospital for overnight observation.
The doctor cleans the wound and looks for broken fangs or dirt. A tetanus shot is required if the patient has not had one within 5 years. Some wounds may require antibiotics to prevent infection.
The emergency medicine doctor may need to consult a surgeon if there is evidence of compartment syndrome. Regardless, most clinicians suggest an early consult of a surgeon to help monitor the patient in case compartment syndrome develops. If treatment with limb elevation and medicines fails, the surgeon may need to cut through the skin into the affected compartment, a procedure called a fasciotomy. This procedure can relieve the increased limb swelling and pressure, potentially saving the arm or leg.