# Snake Bite

- Category: acute
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: WHO Snakebite envenoming - treatment (Control of Neglected Tropical Diseases, who.int)
- Verified date: 2026-08

## Verified against

- WHO Snakebite envenoming - treatment (Control of Neglected Tropical Diseases, who.int)
- Snake Bite - disease-level clinical article (snake-bite-clinical.txt)

## Treatment metadata

- No drug therapy in primary care (Emergency Referral)

## Complete treatment card

```text
SNAKE BITE
Sources: WHO Snakebite envenoming - treatment (Control of Neglected Tropical Diseases, who.int)
Review status: REVIEWED against WHO Snakebite envenoming - treatment (Control of Neglected Tropical
               Diseases, who.int), Snake Bite - disease-level clinical article
               (snake-bite-clinical.txt)  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (1)
    - Nausea, vomiting, belly pain, lethargy, muscle weakness or twitching, and severe headache can
      mark systemic envenomation  [abdominal pain · headache · lethargy · muscle weakness · nausea ·
      vomiting]
  SIGNS - what you find (7)
    - Fang marks at the bite site may or may not be visible on exam
    - Local tissue injury can show bruising, blistering, or outright necrosis  [bruising · necrosis]
    - Neurotoxic envenomation starts with generalized weakness, drooping eyelids, and eye-movement
      paralysis, progressing to facial paralysis and respiratory failure  [paralysis]
    - Active bleeding from the bite wound, nosebleeds, or spontaneous bleeding suggest a hemotoxic
      bite  [bleeding · nosebleed]
    - Shock from venom can arise via vasodilation, low blood volume, or anaphylaxis  [shock]
    - Elapid bites cause little local damage but a neurotoxic syndrome with systemic toxicity,
      pointing to that snake family
    - Viperid bites cause severe local tissue damage with a hemotoxic syndrome and systemic toxicity
  TESTS (6)
    - Suspected hemotoxin exposure calls for CBC, prothrombin time, partial thromboplastin time, and
      fibrinogen
    - Creatine kinase, electrolytes, and urinalysis screen for muscle breakdown and kidney
      involvement
    - Neurotoxicity is followed with end-tidal CO2 monitoring or serial arterial blood gases for
      evolving respiratory acidosis
    - Rapid venom testing can confirm a suspected snake species, but a negative result cannot rule
      one out
    - The bite site is watched closely for spreading swelling, blisters, or compartment syndrome
    - A direct compartment pressure over 30 mm Hg confirms early compartment syndrome
  IF NOT THIS - what else fits (5)
    - Without a witnessed snake bite, scorpion, tick, or spider bites are regional alternatives
    - Guillain-Barre syndrome is a consideration when the pattern is neurotoxic
    - Tick paralysis can mimic the same neurotoxic picture
    - Unexplained coagulopathy warrants work-up for a hereditary cause or an acquired disease such
      as DIC or ITP
    - Local tissue destruction can instead stem from trauma or a soft-tissue infection like
      cellulitis, abscess, or necrotizing fasciitis
  Source  StatPearls "Evaluation and Treatment of Snake Envenomations" - disease-level clinical
          article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (EMERGENCY REFERRAL)   [1st line]
   Adult    Immobilize the bitten limb (splint), keep patient completely still, and arrange
            immediate emergency transport to a hospital equipped with antivenom - Immediate
            emergency transfer
   Peds     Immediate emergency pediatric transport
   Source   WHO Snakebite envenoming - treatment (Control of Neglected Tropical Diseases, who.int)
   Why      Primary care in Egypt rarely stocks appropriate polyvalent antivenom; immediate transfer
            is life-saving.
   Caution  DO NOT apply a tourniquet.
            DO NOT incise, cut, or apply suction to the bite wound.
            DO NOT apply ice or heat to the area.
            Remove rings or constricting items before swelling occurs.
            RED FLAG - Before hospital arrival, do NOT incise the wound, attempt oral or suction
            venom removal, apply ice, or give alcohol. Immobilize, keep the patient still, and
            transfer.
            RED FLAG - Explicit warnings against dangerous lay first-aid practices (tourniquets,
            venom extractors, wound incision/washout) that increase morbidity are missing from the
            advice
            RED FLAG - Signs of severe systemic toxicity, including profound neuromuscular blockade
            leading to diaphragmatic paralysis and respiratory insufficiency, are omitted

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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