🐍 Chapter 768 · Snake Bites

Nelson Textbook of Pediatrics 22nd Edition | Snake bites: Pit vipers (rattlesnakes, copperheads, cottonmouths) – Crotalinae polyvalent immune Fab (CroFab) antivenom, envenomation grading (0-IV), coagulopathy (thrombocytopenia, hypofibrinogenemia). Coral snakes (Elapidae) – neurotoxic venom, antivenin (Micrurus fulvius), respiratory support. Dry bites (~20% pit vipers, 80% coral snakes). Fasciotomy rarely needed if antivenom adequate.

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📋 30 Clinical Scenarios — Snake Bites

📇 High‑Yield Review Cards

🩺 Clinical Recognition: Snake Envenomation

Select a snake bite presentation to review grading, antivenom, and management (Nelson Ch 768).

📋 Stepwise Management of Snake Bites

🔑 Key Principles — Chapter 768
• Pit viper (rattlesnake, copperhead, cottonmouth): CroFab antivenom (ovine Fab). Indications: Grade ≥II (progressive swelling, coagulopathy, systemic symptoms). Initial 4-6 vials IV. Repeat until control. Delayed coagulopathy up to 2 weeks.
• Coral snake: Antivenin (Micrurus fulvius) for any neurologic symptom (ptosis, dysphagia, weakness). Respiratory support. Observe 24h.
• No tourniquets, ice, incision, suction, or electric shock. Immobilize at heart level.
• Fasciotomy only if compartment pressures >30 mmHg despite adequate antivenom.

    ⚡ Reflex Prompts — Snake Bite Emergencies

    📖 Summary: Snake Bites (Nelson 768)