Snake Bites - Dr. Kallgren

• Epidemiology: vast majority of snake bites are from nonvenomous snakes, fatalities extremely rare
  
• Crotalids (vipers) have hemotoxic venom, Elapids (cobras) have neurotoxic venom
  
• Six venomous species in North Carolina, five are vipers so treated with CroFAB
  

Field treatment: don’t make things worse, get to the nearest hospital

In the hospital:                 

1.     ABCs
2.     Wound assessment and pain control
3.     Labs to assess for coagulopathy and rhabdomyolysis
4.     Call poison control – should always talk to toxicologist
5.     CroFAB vs observation only

                                      - Mild/dry bite: no CroFAB, just observation
                                      - Moderate/severe: one or more doses as needed based on wound progression

CroFAB is only curative treatment currently but VERY expensive; Currently evaluating anti-TNFa agents

TNFa pilot study: active now, enrolling nonpregnant healthy adults

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