My What Big Teeth You Have: The Assessment and Current Pharmacologic Treatment of North American Crotalid Snakebite-My What Big Teeth You Have: The Assessment and Current Pharmacologic Treatment of North American Crotalid Snakebite

My What Big Teeth You Have: The Assessment and Current Pharmacologic Treatment of North American Crotalid Snakebite - Video

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Video Summary

This virtual lecture by Gordon Worley from UC Davis covers the assessment and treatment of North American venomous snakebites, focusing on pit vipers (rattlesnakes, cottonmouths, copperheads) and coral snakes. Annually, about 9,000 snakebites occur in the U.S., with around 2,000 envenomations and 5-6 deaths. Pit vipers have triangular heads, facial heat-sensing pits, and vertical pupils, while coral snakes are identifiable by their red, yellow, and black banding ("red on yellow, kill a fellow"). Rattlesnakes are defensive, striking rapidly without always warning by rattling, and inject venom causing pain, swelling, tissue damage, coagulopathy, and occasionally neurotoxicity. About one-third of bites are "dry," with no venom injected. Initial care involves ABCs, calming the victim, removing constrictive items, immobilizing the limb, marking swelling progression, and rapid transport to a hospital for antivenom treatment. Two antivenoms, CroFab (sheep-derived FAB fragment) and Anavip (horse-derived FAB2 fragment), are used for pit viper envenomation, each with different half-lives and administration protocols. Coral snake bites, primarily neurotoxic, require a separate equine whole IgG antivenom. Common myths debunked include rattlesnakes always rattling before striking and baby snakes having more potent venom. Adverse reactions to antivenoms can include anaphylaxis and serum sickness. Patients require 18-24 hours observation post-treatment due to risk of symptom recurrence. Supportive care includes pain management and tetanus prophylaxis; prophylactic antibiotics are generally not recommended. Additional resources include the Wilderness Medical Society and Venom Week Scientific Symposium.

Keywords

North American venomous snakebites

pit vipers

coral snakes

snakebite assessment

antivenom treatment

rattlesnake envenomation

CroFab and Anavip

snakebite myths