Envenomation

Question 1

What type of snake bite?
Signs and Symptoms: ptosis, dysphagia, diplopia, and respiratory arrest via
diaphragmatic paralysis

Answer 1

Neurotoxic (coral snake) -

Question 2

Neurotoxins cause ……

Answer 2

respiratory paralysis

Question 3

________ venoms cause tissue destruction by digestion and hemorrhage due to hemolysis and destruction of the endothelial lining of
the blood vessels.

Answer 3

Cytolytic venoms

Question 4

What snake bite?
Signs and Symptoms:
1) Local pain
2) Redness
3) Swelling
4) Extravasation of blood
5) Perioral tingling
6) Metallic taste
7) Nausea and vomiting
8) Hypotension
9) Coagulopathy

Answer 4

Cytolytic (rattlesnakes, other pit vipers)

Question 5

Treatment snake bites

Answer 5

(a) Remove from threat, try to ID snake
(b) Immobilize the patient and maintain the bitten part in a neutral position.
(c) DO NOT apply a tourniquet or attempt to extract venom!!!
(d) Irrigate and clean the bite
(e) Loose dressing if hemotoxic bite, expect swelling
(f) MEDEVAC

Question 6

True/False
When treating a snake bit you should apply a tourniquet and attempt to extract venom

Answer 6

False
NO DO

Question 7

Hx Bit by a spider
-Signs and Symptoms: Generalized muscular pains, muscle spasms, and rigidity
What type of spider would you suspect? what is the Tx?

Answer 7

Black Widow Spiders
Treatment: Pain may be relieved with pain control and muscle relaxants

Question 8

Hx Bit by a spider
-Sign and Symptoms: Causes progressive local necrosis as well as hemolytic reactions (rare). Bite is usually painless.
What type of spider would you suspect? what is the Tx?

Answer 8

Brown Recluse Spider
Treatment:
1) Pain management for secondary local necrosis and close monitoring initially.
2) Consider antibiotic prophylaxis in field setting
3) Bites that progress to extensive local necrosis may require excision of the bite site and oral corticosteroid

Question 9

Signs and Symptoms:
(a) Muscle cramps
(b) Twitching and jerking
(c) Occasionally hypertension
(d) Convulsion
(e) Pulmonary edema
What would you suspect?
Tx?

Answer 9

Scorpion sting
Treatment:
(a) Supportive care is appropriate for North American species.
(b) Always review the threat of local species when operating OCONUS