Rattlesnake Bite





Local Bite Site Manifestations

Cardiovascular Manifestations

Pulmonary Manifestations

Hematologic Manifestations

Renal Manifestations


Constriction Band Proximal to Bite Site: effective to contain local spread (by compressing superficial veins and lymphatics) only if used within 30 min of bite
-However, avoid a tight tourniquet, as this may increase the risk of necrosis and amputation

Polyvalent Crotalidae Anti-Venin IV (see Crofab, [[Crofab]]): best results if given within 24 hrs of bite
-SE (anti-venin is from horse serum): immediate hypersensitivity (may need to treat through anaphylaxis with Benadryl, IV Epinephrine slow drip, fluids, and steroids) and serum sickness (can occur in <50% of cases)
–Skin testing is relatively insensitive and non-specific in predicting these reactions (although the package insert recommends skin testing prior to administration) -> give anti-venin even if skin test is positive

Wound Infection Prophylaxis: antibiotics/wound cleansing

Tetanus Prophylaxis: Tetanus toxoid

Surgical Fasciotomy: may be required in cases with a complicating compartment syndrome

Not Effective:
1) Vitamin K/Heparin: no role in treating DIC
2) Prophylactic Antibiotics: little evidence these improve outcome
3) Incision and Drainage of Wound in Field: not recommended (due to risks of infection and bleeding)
4) Local Cryotherapy: not recommended (worsens local and systemic manifestations in animal studies)