Rattlesnake Envenomation Clinical Presentation

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6. Ruha AM, Kleinschmidt KC, Greene S, Spyres MB, Brent J, Wax P, et al. The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry. J Med Toxicol. 2017 Dec. 13 (4):309-320. [QxMD MEDLINE Link].

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11. Norris Jr RL, Bush SP. North American venomous reptile bites. Auerbach PS, ed. Wilderness Medicine. 5th ed. 2006.

12. Bush SP, Jansen PW. Severe rattlesnake envenomation with anaphylaxis and rhabdomyolysis. Ann Emerg Med. 1995 Jun. 25(6):845-8. [QxMD MEDLINE Link].

13. Bond RG, Burkhart KK. Thrombocytopenia following timber rattlesnake envenomation. Ann Emerg Med. 1997 Jul. 30(1):40-4. [QxMD MEDLINE Link].

14. Hurlbut KM, Dart RC, et al. Reliability of clinical presentation for predicting significant pit viper envenomation. Ann Emerg Med. 1988. 438-9.

15. Bogdan GM, Dart RC. Prolonged and recurrent coagulopathy after North American pit viper envenomation (abstract). Ann Emerg Med. 1996. 27:820.

16. Boyer LV, Seifert SA, Clark RF, McNally JT, Williams SR, Nordt SP, et al. Recurrent and persistent coagulopathy following pit viper envenomation. Arch Intern Med. 1999 Apr 12. 159(7):706-10. [QxMD MEDLINE Link].

17. Burgess JL, Dart RC. Snake venom coagulopathy: use and abuse of blood products in the treatment of pit viper envenomation. Ann Emerg Med. 1991 Jul. 20(7):795-801. [QxMD MEDLINE Link].

18. Riffer E, Curry SC, Gerkin R. Successful treatment with antivenin of marked thrombocytopenia without significant coagulopathy following rattlesnake bite. Ann Emerg Med. 1987 Nov. 16(11):1297-9. [QxMD MEDLINE Link].

19. McBride KM, Bromberg W, Dunne J. Thromboelastography Utilization in Delayed Recurrent Coagulopathy after Severe Eastern Diamondback Rattlesnake Envenomation. Am Surg. 2017 Apr 1. 83 (4):332-336. [QxMD MEDLINE Link].

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21. French WJ, Hayes WK, Bush SP, Cardwell MD, Bader JO, Rael ED. Mojave toxin in venom of Crotalus helleri (Southern Pacific Rattlesnake): molecular and geographic characterization. Toxicon. 2004 Dec 1. 44(7):781-91. [QxMD MEDLINE Link].

22. Bush SP. Snakebite suction devices don't remove venom: they just suck. Ann Emerg Med. 2004 Feb. 43(2):187-8. [QxMD MEDLINE Link].

23. Bush SP, Hegewald KG, Green SM, Cardwell MD, Hayes WK. Effects of a negative pressure venom extraction device (Extractor) on local tissue injury after artificial rattlesnake envenomation in a porcine model. Wilderness Environ Med. 2000 Fall. 11(3):180-8. [QxMD MEDLINE Link].

24. Bush SP, Green SM, Laack TA, Hayes WK, Cardwell MD, Tanen DA. Pressure immobilization delays mortality and increases intracompartmental pressure after artificial intramuscular rattlesnake envenomation in a porcine model. Ann Emerg Med. 2004 Dec. 44(6):599-604. [QxMD MEDLINE Link].

25. Hardy DL, Bush SP. Pressure/immobilization as first aid for venomous snakebite in the United States. Herpetol Rev. 1998. 29:204-8.

26. Consroe P, Egen NB, Russell FE, Gerrish K, Smith DC, Sidki A, et al. Comparison of a new ovine antigen binding fragment (Fab) antivenin for United States Crotalidae with the commercial antivenin for protection against venom-induced lethality in mice. Am J Trop Med Hyg. 1995 Nov. 53(5):507-10. [QxMD MEDLINE Link].

27. Bush SP, Wu VH, Corbett SW. Rattlesnake venom-induced thrombocytopenia response to Antivenin (Crotalidae) Polyvalent: a case series. Acad Emerg Med. 2000 Feb. 7(2):181-5. [QxMD MEDLINE Link].

28. Bush SP, Green SM, Moynihan JA, Hayes WK, Cardwell MD. Crotalidae polyvalent immune Fab (ovine) antivenom is efficacious for envenomations by Southern Pacific rattlesnakes (Crotalus helleri). Ann Emerg Med. 2002 Dec. 40(6):619-24. [QxMD MEDLINE Link].

29. Dart RC, Seifert SA, Carroll L, Clark RF, Hall E, Boyer-Hassen LV, et al. Affinity-purified, mixed monospecific crotalid antivenom ovine Fab for the treatment of crotalid venom poisoning. Ann Emerg Med. 1997 Jul. 30(1):33-9. [QxMD MEDLINE Link].

30. Baudou FG, Litwin S, Lanari LC, Laskowicz RD, Damin CF, Chippaux JP, et al. Antivenom against Crotalus durissus terrificus venom: Immunochemical reactivity and experimental neutralizing capacity. Toxicon. 2017 Dec 15. 140:11-17. [QxMD MEDLINE Link].

31. Jurkovich GJ, Luterman A, McCullar K, Ramenofsky ML, Curreri PW. Complications of Crotalidae antivenin therapy. J Trauma. 1988 Jul. 28(7):1032-7. [QxMD MEDLINE Link].

32. Trautman W, Pizon A. Severe, persistent thrombocytopenia in Crotalus horridus envenomation despite antivenom: A retrospective review. Toxicon. 2023 Mar 1. 224:107029. [QxMD MEDLINE Link].

33. Clark RF, Selden BS, Furbee B. The incidence of wound infection following crotalid envenomation. J Emerg Med. 1993 Sep-Oct. 11(5):583-6. [QxMD MEDLINE Link].

34. Guisto JA. Severe toxicity from crotalid envenomation after early resolution of symptoms. Ann Emerg Med. 1995 Sep. 26(3):387-9. [QxMD MEDLINE Link].

35. Offerman SR, Bush SP, Moynihan JA, Clark RF. Crotaline Fab antivenom for the treatment of children with rattlesnake envenomation. Pediatrics. 2002 Nov. 110(5):968-71. [QxMD MEDLINE Link].

36. Premawardhena AP, de Silva CE, Fonseka MM, Gunatilake SB, de Silva HJ. Low dose subcutaneous adrenaline to prevent acute adverse reactions to antivenom serum in people bitten by snakes: randomised, placebo controlled trial. BMJ. 1999 Apr 17. 318(7190):1041-3. [QxMD MEDLINE Link].

Sean P Bush, MD, FACEP Professor of Emergency Medicine, The Brody School of Medicine at East Carolina University

Sean P Bush, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, International Society on Toxicology, Society for Academic Emergency Medicine, Wilderness Medical Society

Disclosure: Nothing to disclose.

John T VanDeVoort, PharmD Regional Director of Pharmacy, Sacred Heart and 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.

James Steven Walker, DO, MS Clinical Professor of Surgery, Department of Surgery, University of Oklahoma College of Medicine

James Steven Walker, DO, MS is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, American Osteopathic Association

Disclosure: Nothing to disclose.

Joe Alcock, MD, MS Associate Professor, Department of Emergency Medicine, University of New Mexico Health Sciences Center

Joe Alcock, MD, MS is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Robert L Norris, MD Professor Emeritus, Department of Emergency Medicine, Stanford University Medical Center

Robert L Norris, MD is a member of the following medical societies: American College of Emergency Physicians, Wilderness Medical Society

Disclosure: Nothing to disclose.

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