Venomous Snakebite: Past, Present, And Future Treatment Options

Abstract, Journal of the American Board of Family Practice, 1992

Background: Venomous snakebites continue to cause great morbidity, and treatment options ate confusing the attending physician. In the United States approximately 45,000 snakebites occur eacl1 year, of which some 8000 ate by 20 species of venomous snakes. Methods: Information on venomous snakes and snakebite treatment was gathered from the libraries of the Wilderness Medical Society and the Rocky Mountain Center for WUderness Medicine in Boise, Idaho (co-supported by the Boise State University and the Family Practice Residency of Idaho), as well as &om current literature files of physicians practicing wUderness medicine. Results ",,4 ConelflSlmrs: 1bree genera of venomous snakes account for the majority of poisonous snake envenomations in this country. Most hospitalized victims ate bitten either by rattlesnakes or copperheads or by unidentified snakes. Most of these bites occur during the summer months and ate found on the extremities. Field treatment focuses on the application of a vacuum extractor and transportation to the neatest medical fadlity. Although constriction band use can be helpful, tourniquets, incision and suction, and ice therapy ate contraindicated. Electric shock therapy is of no use and could cause serious injury. Hospital management focuses on rapid clinical evaluation and laboratory tests to establish the degree of envenomation, looking for clotting abnormalities. If envenomation bas occurred and is reactive, polyvalent antivenin should be administered according to the degree of envenomation. Errors in diagnosis and treatment resuh in increased morbidity and put attending physicians at risk for litigation. Prevention remains the most successful approach to snakebite management. a Am Board Fam Prac:t 1992; 5:399-405.)