Page 227 - ATP-P 11th Ed

ENVENOMATION PROTOCOL

Snake Envenomations Protocol

SPECIAL CONSIDERATIONS
GENERAL:
1. Toxic envenomations from a variety of sources, including insects, spiders,
bees/wasps, scorpions, snakes, or marine life are all capable of causing life- SECTION 2
threatening anaphylaxis and should be treated according to the Anaphylactic
Reaction Protocol.
SNAKES:
1. Only a minority of snakebites from toxic snakes involve severe, life-threatening
envenomations.
2. Incision, excision, electrical shock, tourniquet, oral suction, and cryotherapy
should NOT be performed to treat snakebites.
3. Suction device is not effective for removing snake venom from a wound. If pre-
viously placed, it should be left in place until patient reaches higher level of care.

Snake Signs and Symptoms
1. Crotalidae (pit vipers, rattlesnake, moccasin, bushmaster)
a. Sudden pain
b. Erythema
c. Ecchymosis
d. Hemorrhagic bullae
e. Bleeding from site
f. Metallic taste
g. Hypotension/shock
h. Swelling/edema
2. Elapids (Coral snake, sea snake, mamba, cobra, taipan, kraits)
a. Cranial Nerve dysfunction (i.e., ptosis, difficulty swallowing)
b. Paresthesias
c. Fasciculations
d. Weakness
e. Altered mental status

216 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 217