Coral Snake Envenomation Follow-up
- Author: Robert L Norris, MD; Chief Editor: Joe Alcock, MD, MS more...
Further Inpatient Care
Admit all persons bitten by a coral snake to a closely monitored facility, whether or not antivenom is given.
Observe asymptomatic patients for at least 24 hours because delayed signs and symptoms may occur.
If an appropriate antivenom was available and administered, but resulted in an acute reaction, continue to administer systemic antihistamines and steroids as needed.
Generally, little or no risk of tissue necrosis is present following coral snake bites.
Inform patients who have received antivenom of the signs and symptoms of delayed serum sickness. If symptoms of serum sickness develop after discharge, promptly evaluate the patient for initiation of systemic steroids and diphenhydramine (see Medications).
Avoid handling venomous or unidentified snakes.
Use caution when placing bare hands or feet into areas where one cannot see and in which snakes may be seeking shelter.
Complications of snake bite may include the following:
Prolonged neuromuscular weakness
Antivenom-related complications - Nonallergic anaphylaxis ( anaphylactoid reactions), delayed serum sickness
With sound supportive care (eg, prevention of aspiration) and appropriate antivenom administration, when available, prognosis following coral snake envenomation is excellent; expect a full recovery. This is generally true, even in the absence of an available, appropriate antivenom, but the overall clinical course (including the need for prolonged intubation and respiratory support) will be longer. Patients who survive the bite may require respiratory support for up to a week and may suffer persistent weakness for weeks to months.
A single death has been reported due to a coral snake bite in the United States in the last 40 years (roughly, since coral snake antivenom became available). Before that time, the estimated case-fatality rate was 10%, and the cause of death was respiratory or cardiovascular failure.
For excellent patient education resources, see eMedicineHealth's patient education article Snakebite.
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