Approach and management of venomous snake bites: a guide for the primary care physician

Approximately 10,000 snake bites occur each year in the United States. Although rarely fatal, 70% of envenomations require antivenom therapy. The rattlesnake, a member of the Crotalinae family, causes the most bites and fatalities each year. First aid techniques such as arterial tourniquet, mechanical venom removal, and icing the wound-which are ineffective and actually cause more harm-have been replaced with immobilization of the affected extremity at a gravity-neutral position and aggressive antivenom therapy. Patients with snake bite injuries should be seen in the emergency department and antivenom therapy should be initiated if indicated. Fasciotomies are reserved for rare cases, although prevention and education of snake bites should be the goal of all physicians.