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Snake Envenomation, Coral: Differential Diagnoses & Workup

Author: Robert L Norris, MD, Associate Professor, Department of Surgery; Chief, Division of Emergency Medicine, Stanford University Medical Center
Contributor Information and Disclosures

Updated: Dec 17, 2008

Differential Diagnoses

Snake Envenomations, Brown
Snake Envenomations, Cobra
Snake Envenomations, Moccasins
Snake Envenomations, Mohave Rattle
Snake Envenomations, Rattle
Snake Envenomations, Sea

Workup

Laboratory Studies

  • No laboratory studies are of diagnostic benefit. Baseline laboratory studies (eg, complete blood count [CBC], electrolyte tests, renal function studies) may be obtained in severe bite cases or if the patient has significant underlying medical problems. Coagulation studies are not indicated.
  • An arterial blood gas (ABG) determination may be helpful if the patient's respiratory status is of concern.

Imaging Studies

  • A chest radiograph is beneficial in patients who have severe envenomation, who require intubation, or who show evidence of cardiopulmonary failure.

More on Snake Envenomation, Coral

Overview: Snake Envenomation, Coral
Differential Diagnoses & Workup: Snake Envenomation, Coral
Treatment & Medication: Snake Envenomation, Coral
Follow-up: Snake Envenomation, Coral
Multimedia: Snake Envenomation, Coral
References

References

  1. Watson WA, Litovitz TL, Rodgers GC Jr, et al. 2004 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. Sep 2005;23(5):589-666. [Medline].

  2. Davidson TM, Eisner J. United States coral snakes. Wilderness Environ Med. 1996;1:38-45.

  3. German BT, Hack JB, Brewer K, et al. Pressure-immobilization bandages delay toxicity in a porcine model of eastern coral snake (Micrurus fulvius fulvius) envenomation. Ann Emerg Med. Jun 2005;45(6):603-8. [Medline].

  4. Gray S. Pressure immobilization of snakebite. Wilderness Environ Med. Spring 2003;14(1):70-1. [Medline].

  5. Kitchens CS, Van Mierop LH. Envenomation by the Eastern coral snake (Micrurus fulvius fulvius). A study of 39 victims. JAMA. Sep 25 1987;258(12):1615-8. [Medline].

  6. Norris RL, Bush SP. North American venomous reptile bites. In: Auerbach PS, ed. Wilderness Medicine. 4th ed. St. Louis: Mosby; 2001:896-926.

  7. Norris RL, Dart RC. Apparent coral snake envenomation in a patient without visible fang marks. Am J Emerg Med. Jul 1989;7(4):402-5. [Medline].

  8. Norris RL, Ngo J, Nolan K, et al. Physicians and lay people are unable to apply pressure immobilization properly in a simulated snakebite scenario. Wilderness Environ Med. 2005;16(1):16-21. [Medline].

  9. Parrish HM, Khan MS. Bites by coral snakes: report of 11 representative cases. Am J Med Sci. May 1967;253(5):561-8. [Medline].

  10. Simpson ID, Tanwar PD, Andrade C, et al. The Ebbinghaus retention curve: training does not increase the ability to apply pressure immobilisation in simulated snake bite--implications for snake bite first aid in the developing world. Trans R Soc Trop Med Hyg. May 2008;102(5):451-9. [Medline].

Further Reading

Keywords

snake envenomation, snakebite, snake bite, coral snake, Elapidae, Micrurus fulvius, eastern coral snake, Micrurus tener, Texas coral snake, coral snake envenomations, coral snake bite, Micruroides euryxanthus, Sonoran coral snake, Arizona coral snake

Contributor Information and Disclosures

Author

Robert L Norris, MD, Associate Professor, Department of Surgery; Chief, Division of Emergency Medicine, Stanford University Medical Center
Robert L Norris, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, California Medical Association, International Society of Toxinology, Society for Academic Emergency Medicine, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Edmond A Hooker II, MD, DrPH, FAAEM, Assistant Professor, Department of Health Services Administration, Xavier University; Associate Clinical Professor, Department of Emergency Medicine, University of Louisville; Assistant Clinical Professor, Department of Emergency Medicine, Wright State University
Edmond A Hooker II, MD, DrPH, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Public Health Association, Society for Academic Emergency Medicine, and Southern Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

John T VanDeVoort, PharmD, Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals
John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists
Disclosure: Nothing to disclose.

Managing Editor

David Eitel, MD, MBA, Associate Professor, Department of Emergency Medicine, York Hospital
David Eitel, MD, MBA is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Jonathan Adler, MD, Attending Physician, Department of Emergency Medicine, Massachusetts General Hospital; Division of Emergency Medicine, Harvard Medical School
Jonathan Adler, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: eMedicine.com, Inc. Consulting fee Consulting

 
 
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