Fast Five Quiz: Snakebite Facts vs Fiction

Richard H. Sinert, DO

Disclosures

July 12, 2021

Determine the time of the bite and what signs and symptoms have developed. Inquire about local effects as well as systemic symptoms including nausea, dyspnea, a metallic taste, muscle fasciculations, and lightheadedness.

History usually can be obtained from the patient, although some patients do not see the snake and many patients cannot correctly identify the snake. Identifying the species of snake can be helpful if it expedites treatment, facilitates crotaline antivenom selection where relevant, or enables experts to tailor therapy. However, victims and emergency medical service providers should be discouraged from bringing in the snake because even a dead snake can envenomate.

Neurologic toxicity is not associated with most crotalid envenomations, but envenomations from some species (eg, Mojave rattlesnake, Southern Pacific rattlesnake) may result in significant weakness and other neurologic abnormalities. Coral snake envenomation may also be associated with nonspecific systemic symptoms, but the hallmark of coral snake envenomation is neurologic toxicity, which may be as subtle as local paresthesias and myokymia or as severe as skeletal and respiratory muscle paralysis.

Although prophylactic antibiotic use after snakebite is common, various studies have shown that it is not routinely indicated. Many experts now recommend that antibiotic administration should only be considered in those with local or general signs of infection or those with severe local signs of envenomation.

Read more about the presentation of patients with snakebites.

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