Few physicians have experience treating snakebites, and a poison center should be consulted in all cases.
All snakebites should be copiously irrigated and inspected for foreign bodies or tendon damage. Infection is rare and prophylactic antibiotics are generally not indicated.
Crotalinae (pit viper) envenomation may cause significant local and systemic effects including rhabdomyolysis, compartment syndrome, coagulopathy, pulmonary edema, and hypotension.
Crotalinae antivenom (Crotalidae polyvalent immune Fab) should be administered in Crotalinae envenomations with worsening local toxicity or systemic symptoms.
The first sign of Elapidae (coral snake) envenomation is frequently ptosis. Paralysis of the muscles of respiration may ensue, leading to morbidity and mortality.
Elapidae antivenom (antivenin, North American coral snake) should be administered in all confirmed Eastern coral snake envenomations to arrest progression of toxicity.
Localized edema following Crotalinae envenomation
From the personal collection of Dr Michael Greenberg; used with permission