Snakebites worldwide: Management
- Julian White, AM, MB, BS, MD, FACTM
Julian White, AM, MB, BS, MD, FACTM
- The University of Adelaide
- Section Editors
- Daniel F Danzl, MD
Daniel F Danzl, MD
- Section Editor — Environmental Emergencies
- Professor of Emergency Medicine
- University of Louisville School of Medicine
- Stephen J Traub, MD
Stephen J Traub, MD
- Section Editor — Toxicology
- Associate Professor of Emergency Medicine
- Mayo Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — Adult and Pediatric Emergency Medicine
- Senior Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
Snakebites account for significant morbidity and mortality worldwide, especially in South and Southeast Asia, sub-Saharan Africa, and Latin America . Venomous snakes are widely distributed around the world and clinical effects from envenomation can overlap to a great degree even among different families of snakes. This topic will discuss the management of snakebites that occur worldwide, other than those by snakes found in the United States.
The clinical manifestations and diagnosis of snakebites worldwide and the principles of management of snakebites within the United States are discussed separately. (See "Snakebites worldwide: Clinical manifestations and diagnosis" and "Evaluation and Management of Crotalinae (rattlesnake, water moccasin [cottonmouth], or copperhead) bites in the United States" and "Evaluation and management of coral snakebites".)
Although common names are used to describe snakes throughout this topic, the genus and species that correlate with the common names can be found in the following tables for Africa (table 1), Asia (table 2), Central and South America (table 3), Australia and the Pacific Islands (table 4), Europe (table 5), and the Middle East (table 6) and at the following website: WHO snake and antivenom database.
CLINICAL MANIFESTATIONS AND DIAGNOSIS
The clinical manifestations and diagnosis of snakebite worldwide are discussed separately. (See "Snakebites worldwide: Clinical manifestations and diagnosis".)
Initial first aid of snake envenomation is directed at reducing the spread of venom and expediting transfer to an appropriate medical center.
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- CLINICAL MANIFESTATIONS AND DIAGNOSIS
- FIRST AID
- General principles
- - Pressure immobilization
- Methods to avoid
- - Initial stabilization
- Respiratory failure
- Local wound care
- - Known snake species
- - Unknown snake species
- - Asymptomatic (dry bite)
- - Indications
- - Obtaining antivenom
- - Administration
- - Response to treatment
- - Failure to respond
- - Allergic reactions
- - Contraindications
- Treatment other than antivenom
- - Local effects
- - Neurotoxicity
- - Coagulopathy
- Blood products
- Other agents
- - Hypotension
- - Rhabdomyolysis
- - Renal failure
- - Cobra spit ophthalmia
- Other therapies
- - Tetanus prophylaxis
- - Antibiotics
- ADDITIONAL RESOURCES
- SUMMARY AND RECOMMENDATIONS