Elapidae (Coral Snakes): Difference between revisions
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===Antivenom=== | ===Antivenom=== | ||
*Give 3-5 vials of Antivenin to ALL pts who have definitely been bitten | *Give 3-5 vials of Antivenin (Micrurus fulvius) to ALL pts who have definitely been bitten | ||
**It may not be possible to prevent further effects or reverse effects once they develop | **It may not be possible to prevent further effects or reverse effects once they develop | ||
**Additional doses of antivenom are reserved for cases in which symptoms/signs appear | **Additional doses of antivenom are reserved for cases in which symptoms/signs appear | ||
*Prepare for allergic reaction from equine produced Antivenin (may dilute solution, or administer with epinephrine/benadryl) | |||
===Monitor for [[respiratory failure]]=== | ===Monitor for [[respiratory failure]]=== | ||
Revision as of 00:48, 30 December 2015
Background
- All coral snakes are brightly colored with black, red, and yellow rings
- Red and yellow rings touch in coral snakes, but are separated in nonpoisonous mimics
- "Red touch yellow, kills a fellow; red touch black, venom lack"
- Red and yellow rings touch in coral snakes, but are separated in nonpoisonous mimics
Clinical Features
- Local injury is often minimal
- Venom effects may develop hours after a bite
Differential Diagnosis
Envenomations, bites and stings
- Hymenoptera stings (bees, wasps, ants)
- Mammalian bites
- Closed fist infection (Fight bite)
- Dog bite
- Marine toxins and envenomations
- Toxins (ciguatera, neurotoxic shellfish poisoning, paralytic shellfish poisoning, scombroid, tetrodotoxin
- Stingers (stingray injury)
- Venomous fish (catfish, zebrafish, scorpion fish, stonefish, cone shells, lionfish, sea urchins)
- Nematocysts (coral reef, fire coral, box jellyfish, sea wasp, portuguese man-of-war, sea anemones)
- Phylum porifera (sponges)
- Bites (alligator/crocodile, octopus, shark)
- Scorpion envenomation
- Reptile envenomation
- Spider bites
Treatment
Local Care
- Do:
- Remove all jewelry
- Mark the leading edge of erythema/edema
- Do not:
- Attempt to suck out the venom
- Place the affected part in cold water
- Use a tourniquet or wrap
- Antivenom is first line treatment for compartment syndrome; fasciotomy is last resort if elevated pressures persist.
Antivenom
- Give 3-5 vials of Antivenin (Micrurus fulvius) to ALL pts who have definitely been bitten
- It may not be possible to prevent further effects or reverse effects once they develop
- Additional doses of antivenom are reserved for cases in which symptoms/signs appear
- Prepare for allergic reaction from equine produced Antivenin (may dilute solution, or administer with epinephrine/benadryl)
Monitor for respiratory failure
Disposition
- Admit all pts (even if initially symptom free)
Source
Tintinalli