APPENDIX F: NORTHCOM TREATMENT GUIDELINES

Safe and effective antivenoms are available for all neurotoxic/hemo/cytotoxic pit viper envenomations and for neurotoxic coral snake envenomations in this AOR. Treatment does not require identification of the species responsible. Snakebite treatment at the point of injury is not routinely recommended for NORTHCOM.

For all NORTHCOM antivenoms, refer to the package insert in the antivenom box for specific usage instructions as per FDA regulations for domestically approved products. Also see Unified treatment algorithm for the management of crotaline snakebite in the U.S. (Lavonas et al. 2011) for dosing and management guidelines on pit viper bites.101 This section provides specifics about antivenoms use in this region.

Adverse Reaction Management

- If a mild or moderate reaction occurs, slow the infusion, and treat symptomatically with antihistamines, steroids, and/or antiemetics as needed.
- If a severe reaction such as anaphylaxis occurs, stop the infusion, and treat according to the anaphylaxis protocol listed elsewhere in the CPG. Reassess the patient once the reaction has been controlled and resume the infusion at a slower rate if any of the specific criteria for antivenom treatment listed elsewhere in the CPG have not completely resolved.

CONTACT

For emergency consultations, or additional information about snake bite management or this CPG, call the ADVISOR telemedicine hotline 833-ADVSRLN (833-238-7756) / DSN: 312-429-9089 and select toxicology from the phone

First Line Antivenoms – NORTHCOM

NORTHCOM Antivenom Selection Flowchart

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NORTHCOM – Short Form Antivenom Guide

NORTHCOM –Long Form Antivenom Guide

United States & Canada

United States & Canada

United States & Canada (USA: AL, AR, AZ, FL, GA, LA, MS, NM, NC, OK, SC, TX)

Mexico

Mexico

Mexico