Clinical Pearls on Snakebites and Antivenom Treatment

1. Not all snakes are venomous and not all snake bites result in snake envenomations!

2. Roughly 25% of bites from dangerously venomous snakes are harmless “dry bites” where no venom is injected!

3. Snakebite treatment should always be determined by the clinical presentation and evolution of signs and symptoms in the patient rather than the identity of the snake that bit them!

4. There are no absolute contraindications to antivenom for patients with symptomatic snake envenomations. The high risk of permanent damage posed by untreated venom in the body is far greater than the low risk of anaphylaxis associated with high-quality modern antivenoms.

5. Establish a timeline and trend changes over time. Serial assessments and documentation are essential because the resolution of certain clinical findings will be used to determine when the right dose of antivenom has been given. At a minimum always document the following:

6. Snakebites are clinically dynamic emergencies and can change dramatically until control has been achieved.