Snake Bite

A snakebite becomes an envenomation problem when venom effects are present or developing; fang marks alone do not determine severity. In North America, pit vipers include rattlesnakes, copperheads, and cottonmouths. Their venom acts through three overlapping pathways: - Local tissue injury: pain, ecchymosis, and swelling that expands along the limb. - Hematologic toxicity: thrombocytopenia, hypofibrinogenemia, and prolonged prothrombin time from venom-related consumption and interference with coagulation. - Systemic toxicity: hypotension, nausea or vomiting, angioedema, fasciculations, or myokymia. The finding an experienced nurse notices first is not merely how large the swelling is. It is whether the leading edge continues to move. A patient whose ankle swelling reaches the lower leg during serial checks is deteriorating even if the initial examination looked reassuring. Coral snake venom produces a different pattern. Local injury may be limited, while neurotoxicity causes descending neuromuscular weakness: ptosis, dysphagia, impaired speech, progressive weakness, and potentially respiratory failure. Hypotension, airway compromise, altered consciousness, active bleeding, rapidly advancing swelling crossing a major joint, or new coral-snake neuromuscular findings require emergency escalation. Children can develop more severe effects because the...