Emergency Department Management of North American Snake Envenomations (Trauma CME and Pharmacology CME)

Emergency Department Management of North American Snake Envenomations (Trauma CME and Pharmacology CME) is organized by EB Medicine.

Date of Original Release: September 01, 2018
Date of most recent review: August 10, 2018
Termination date: September 01, 2021
CME Expiration Date: September 30, 2021

Target Audience:
This enduring online cme material is designed for emergency medicine physicians, physician assistants, nurse practitioners, and residents.

CME Credits:
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits.

Description:
Venomous native North American snake families incorporate the pit vipers (copperheads, water moccasins/cottonmouths, and rattlesnakes) and coral snakes. Pit viper venom is coagulopathic, and coral snake venom is neurotoxic - so what are the variations in ED management between the 2 types of envenomations? This edition presents the best data behind some of the conflicting recommendations, local practices, and “folklore” surrounding snakebites:
•  Ice, pressure immobilization, incision, and suction: are they still recommended?
•  How can you tell whether - and how much - venom was injected?
•  Why you must mark and time edema and erythema from a snakebite
•  What can antivenom do - and not do?
•  What are the antivenom options for coral snake bites?
•  When is airway compromise a concern, and will antivenom reverse it?
•  Is there a greater risk for anaphylaxis from the snakebite or the antivenom?
•  What is the likelihood of bleeding days or weeks after a snakebite?
•  What are the different observation time recommendations, based on the type of snake and bite severity?

Objectives:
At the completion of this article, you should be able to:
• Explain the evaluation, management, and disposition of patients presenting with envenomations from North American pit vipers and coral snakes.
• Prepare the indications, contraindications, and dosing for antivenom products for snakebites.
• Conduct anaphylactic and anaphylactoid reactions from venom and antivenom.
• Catalog and manage late or recurrent coagulopathy.