Elapidae (Coral Snakes)

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"

Coral snake.

Clinical Features

1. Local injury is often minimal
2. 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
  • Snake bites
    • Crotaline (Pit Vipers)
    • Elapidae (Coral Snakes)
  • Lizard bites
• Spider bites
  • Black widow
  • Brown recluse
  • Tarantula
  • Funnel-web spider bite
  • Armed spider bite

Treatment

1. Antivenom
   1. Give 3-5 vials of Antivenin to ALL pts who have definitely been bitten
      1. It may not be possible to prevent further effects or reverse effects once they develop
      2. Additional doses of antivenom are reserved for cases in which symptoms/signs appear
2. Monitor for respiratory respiratory failure

Disposition

• Admit all pts (even if initially symptom free)

Source

Tintinalli

See Also

• Snake bites