In most areas of Texas, snake bite is an uncommon medical emergency, and
one with which few doctors have had experience. For this reason, the
following recommendations by the National Research Council’s Division of
Medical Sciences are included for the benefit of the physician.
_Statement on Hospital Care Following Bites by Venomous Snakes_
_December 14, 1960_
_Admission Procedures_
The routine admission history and physical examination should provide
and record, if possible, the identity and length of the snake, the time
of the bite, and the details of all first aid measures employed,
including the time lapse for each and the mode of transportation to the
hospital. The record should state whether a tourniquet, incision and
suction, or the ligature-cryotherapy technique has or has not been used.
Inquiry should be made concerning previous bites, allergic
manifestations in general, and whether or not the patient had previously
received horse serum. The admission examination should provide
information from which the severity of the envenomation can be estimated
as a guide to the need for the administration of antivenin and other
therapy. Sensitivity tests should be instituted promptly during
admission if not previously begun.
When the patient enters the hospital, blood should be drawn immediately
for typing, matching and coagulation studies.
Although envenomation by one of the snakes of North America may present
severe signs and symptoms, death is rare except in children or following
envenomation by a large snake. However, permanent damage of an involved
extremity is frequent following a bite by certain of the North American
venomous snakes; plastic or orthopedic surgical repair to restore
function, or amputation, are not unusual consequences. Early and
continuing close observation is needed to determine if certain
therapeutic measures prevent or promote undesirable results.
_Laboratory Tests_
No rigid set of rules regarding therapy can be justified; the
responsible physician must use his best judgment in his choice of tests
to be performed as a guide to procedures to be used.
Clinical studies could include items such as repeated hematologic tests,
hepatic and renal function studies, serial electrocardiograms,
electroencephalograms, and other studies to therapy, depending on the
composition of the venom involved and within the limits of personnel,
time and equipment available.
_Therapeutic Procedures_