Antivenom dosing, preparation, and administration recommendations vary by product. Coverage, initial dosing, preparation, and administration of antivenoms are included in this CPG. Refer to guidelines for the specific product prior to administering the antivenom.
1. The presence of one or more of the criteria for each category in Table 1 (universal treatment) is generally sufficient to diagnose the syndrome, determine severity, and initiate treatment. Patients who present with “mixed syndromes” (signs and symptoms of > 1 syndrome present) receive the same initial doses of antivenom as those presenting with a single syndrome.
To identify the appropriate antivenom and initial dosing for your patient, refer to the regionally-specific snakebite treatment for each combatant command section later in this document. Each COCOM section includes instructions on preparation, dosing, and administration of each antivenom.
2. In certain instances, pretreatment with a low dose of SQ epinephrine prior to antivenom administration may be recommended to reduce the risk of an adverse reaction to antivenom therapy. Refer to pretreatment with epinephrine to prevent early adverse reactions for specific guidelines on pretreatment.
3. The majority of severe early reactions to antivenom occur within the first 5 - 60 minutes after antivenom administration. Observe and monitor the patient closely at the bedside for a minimum of one hour after each dose of antivenom has been given.
Refer to management of mild, moderate, and severe antivenom reactions for specific guidelines on how to manage mild, moderate, or severe reactions to antivenom therapy