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OVERVIEW OF TREATMENT OF SNAKEBITE

First Aid

First aid is the vital first step in managing a snakebite. Correct first aid can delay major envenoming, improving the chance of a good outcome for the patient. Bad first aid, unfortunately more common, may worsen the likely outcome for the patient.

Details of first aid are given on the relevant linked pages.

Hospital management

Suspected snakebite is a medical emergency. While most cases may ultimately prove minor, severe cases become rapidly worse without treatment and the degree of severity may not be immediately obvious. Therefore all cases of suspected snakebite should be triaged as priority cases, requiring urgent assessment. All cases should be admitted, preferably to an ICU or HDU, never to an infrequently checked side room in a standard ward.

Diagnosis

Diagnosis of snakebite is sometimes simple (the snake keeper bitten by their pet), but often difficult and occasionally obscure. This is especially true for children, who may present with sudden unexplained collapse and convulsions following snakebite, with neither history of a snakebite, nor visible bite marks. Think of snakebite in the differential diagnosis of patients presenting with unexplained collapse, convulsions, progressive flaccid paralysis, myolysis, coagulopathy or renal damage.

Diagnosis is covered in more detail in a series of linked pages.

Medical Treatment

There are many aspects to effective treatment of snakebite. They start with a correct approach to managing envenoming cases. There are urgent measures that may be needed. For significant envenoming, antivenom is generally the treatment of choice, though it is only available for some species and some major species are currently not covered by any antivenom.

Medical treatment is covered in more detail in a series of linked pages for subscribers.