Elapidae (Coral Snakes) - Revision history

Athorne: /* Monitor for respiratory failure */

2021-08-02T01:19:43Z

Monitor for respiratory failure

← Older revision		Revision as of 01:19, 2 August 2021
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	===Monitor for [[respiratory failure]]===		===Monitor for [[respiratory failure]]===
			*Respiratory failure results from neurotoxicity rather than edema as in crotalids
			*Frequently reevaluate respiratory function and ability to handle secretions
			**Consider bedside spirometry testing
			*Aggressive airway management with any sign of respiratory decline including mechanical ventillation as needed

	==Disposition==		==Disposition==

Athorne: /* Management */

2021-08-02T00:57:00Z

Management

← Older revision		Revision as of 00:57, 2 August 2021
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	==Management==		==Management==
	{{Snake bite local treatment}}		{{Snake bite local treatment}}
	*[[Pressure Immobilization Dressing]]		*[[Pressure Immobilization Dressing]]<ref>Robert L. Norris, Sean P. Bush, Michael D. Cardwell. Bites by Venomous Reptiles in the United States, Canada, and Mexico. Paul S. Auerbach. In: Auerbach’s Wilderness Medicine. 7th Ed. 2017: 742.</ref>
	**Wrap the length of the bitten extremity with an elastic bandage		**Wrap the length of the bitten extremity with an elastic bandage
	**Splint the extremity in neutral position to immobilize		**Splint the extremity in neutral position to immobilize

Athorne: /* Management */

2021-08-02T00:53:23Z

Management

← Older revision		Revision as of 00:53, 2 August 2021
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	==Management==		==Management==
	{{Snake bite local treatment}}		{{Snake bite local treatment}}
			*[[Pressure Immobilization Dressing]]
			**Wrap the length of the bitten extremity with an elastic bandage
			**Splint the extremity in neutral position to immobilize
			**Immobilize victim and transport to medical care
			**''If a patient presents with a tourniquet or pressure immobilization dressing, obtain IV access for potential resuscitation before removing.''

	===Antivenom===		===Antivenom===

Elcatracho: /* Background */

2021-01-15T20:33:36Z

Background

← Older revision		Revision as of 20:33, 15 January 2021
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	==Background==		==Background==
			*Coral snakes are the only ''Elapidae'' family members found in the United States
			**Internationally, species include sea snakes, cobras, mambas, and kraits
	*All coral snakes are brightly colored with black, red, and yellow rings		*All coral snakes are brightly colored with black, red, and yellow rings
	*Red and yellow rings touch in coral snakes, but are separated in nonpoisonous mimics		*Red and yellow rings touch in coral snakes, but are separated in nonpoisonous mimics

ClaireLewis at 17:37, 28 September 2019

2019-09-28T17:37:29Z

← Older revision		Revision as of 17:37, 28 September 2019
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	**This tool for identifying coral snakes '''does not apply to Mexican species'''		**This tool for identifying coral snakes '''does not apply to Mexican species'''
	[[File:Coral 009.jpg\|thumb\|Coral snake.]]		[[File:Coral 009.jpg\|thumb\|Coral snake.]]
	~~===~~Venom~~===~~		*Venom: mainly neurotoxic (irreversibly binds to acetylcholine receptors)
	~~Coral snake venom is~~ mainly neurotoxic (irreversibly binds to acetylcholine receptors) ~~and does~~ not cause significant local tissue injury unlike [[Crotaline (Pit Vipers)]] venom.		**Does ''not'' cause significant local tissue injury unlike [[Crotaline (Pit Vipers)]] venom.

	==Clinical Features==		==Clinical Features==

ClaireLewis at 16:49, 26 August 2019

2019-08-26T16:49:16Z

← Older revision		Revision as of 16:49, 26 August 2019
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	===Serious complications===		===Serious complications===
	*Venom-induced consumption coagulopathy (DIC-like syndrome)<ref>Isbister GK. Snakebite does not cause disseminated intravascular coagulation: coagulopathy and thrombotic microangiopathy in snake envenoming. Semin Thromb Hemost. 2010 Jun;36(4):444-51.</ref>		*Systemic signs may be delayed up to 13h after bite<ref>http://www.emdocs.net/management-of-venomous-snake-bites-in-north-america/</ref>
	*Renal failure		*Neurotoxicities in particular for coral snakes
	*Hypovolemic shock		**Local [[numbness]] rather than pain/swelling
	*Neurotoxicities in particular for coral snaktes		**[[Cranial nerve palsies]]
	**Local numbness rather than pain/~~swelling~~		**[[Altered mental status]]
	**CN palsies		**[[Weakness]]
	**Respiratory paralysis		**[[Respiratory failure]] due to paralysis
			*Hypovolemic [[shock]]
			*Venom-induced consumption coagulopathy ([[DIC]]-like syndrome)<ref>Isbister GK. Snakebite does not cause disseminated intravascular coagulation: coagulopathy and thrombotic microangiopathy in snake envenoming. Semin Thromb Hemost. 2010 Jun;36(4):444-51.</ref> (uncommon, but reported<ref>https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/elapidae</ref>)

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	*CBC with diff		*CBC with diff
	*PT/PTT/INR		*[[DIC]] labs: PT/PTT/INR, fibrinogen, fibrin degradation products, [[d-dimer]]
	*Fibrinogen
	*Fibrin degradation products
	*BMP		*BMP
	*~~LFT~~		*[[LFTs]]
	*CK		*CK
	*ABG if respiratory compromise

	==Management==		==Management==

DrKarb: /* Venom */

2018-02-15T20:49:01Z

Venom

← Older revision		Revision as of 20:49, 15 February 2018
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	[[File:Coral 009.jpg\|thumb\|Coral snake.]]		[[File:Coral 009.jpg\|thumb\|Coral snake.]]
	===Venom===		===Venom===
	Coral snake venom is mainly neurotoxic and does not cause significant local tissue injury unlike [[Crotaline (Pit Vipers)]] venom		Coral snake venom is mainly neurotoxic (irreversibly binds to acetylcholine receptors) and does not cause significant local tissue injury unlike [[Crotaline (Pit Vipers)]] venom.

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: Text replacement - " resp " to " respiratory "

2016-08-03T23:45:42Z

Text replacement - " resp " to " respiratory "

← Older revision		Revision as of 23:45, 3 August 2016
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	*LFT		*LFT
	*CK		*CK
	*ABG if ~~resp~~ compromise		*ABG if respiratory compromise

	==Management==		==Management==

Rossdonaldson1: Text replacement - "doesn't" to "does not"

2016-08-01T14:02:22Z

Text replacement - "doesn't" to "does not"

← Older revision		Revision as of 14:02, 1 August 2016
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	===Serious complications===		===Serious complications===
	*Venom-induced consumption coagulopathy (DIC-like syndrome)<ref>Isbister GK. Snakebite ~~doesn't~~ cause disseminated intravascular coagulation: coagulopathy and thrombotic microangiopathy in snake envenoming. Semin Thromb Hemost. 2010 Jun;36(4):444-51.</ref>		*Venom-induced consumption coagulopathy (DIC-like syndrome)<ref>Isbister GK. Snakebite does not cause disseminated intravascular coagulation: coagulopathy and thrombotic microangiopathy in snake envenoming. Semin Thromb Hemost. 2010 Jun;36(4):444-51.</ref>
	*Renal failure		*Renal failure
	*Hypovolemic shock		*Hypovolemic shock

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T02:43:46Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 02:43, 22 July 2016
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	{{Bites and stings DDX}}		{{Bites and stings DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*CBC with diff		*CBC with diff
	*PT/PTT/INR		*PT/PTT/INR