Chapter: Basic & Clinical Pharmacology : Management of the Poisoned Patient

Toxic Syndromes: Rattlesnake Envenomation

In the USA, rattlesnakes are the most common venomous reptiles. Bites are rarely fatal, and 20% do not involve envenomation.

RATTLESNAKE ENVENOMATION

In the USA, rattlesnakes are the most common venomous reptiles. Bites are rarely fatal, and 20% do not involve envenomation. However, about 60% of bites cause significant morbidity due to the destructive digestive enzymes found in the venom. Evidence of rattlesnake envenomation includes severe pain, swelling, bruising, hemorrhagic bleb formation, and obvious fang marks. Systemic effects include nausea, vomiting, muscle fasciculations, tingling and metallic taste in the mouth, shock, and systemic coagulopathy with prolonged clotting time and reduced platelet count.

Studies have shown that emergency field remedies such as inci-sion and suction, tourniquets, and ice packs are far more damag-ing than useful. Avoidance of unnecessary motion, on the other hand, does help to limit the spread of the venom. Definitive therapy relies on intravenous antivenom (also known as antivenin) and this should be started as soon as possible.

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Basic & Clinical Pharmacology : Management of the Poisoned Patient : Toxic Syndromes: Rattlesnake Envenomation |