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Myths About Treatment

Myths About Treatments for North American Pit Viper Envenomation

Time Is Tissue.

In the event of a venomous snakebite, it can be just as important to know what NOT to do.

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Avoid the following actions in the event of a pit viper envenomation:

  • Tourniquets1-3
  • Extraction devices (cutting or applying suction to the bite site)1
  • NSAIDs1
  • Steroids (except for allergic phenomena)1
  • Electric shock (e.g., tasers/electricity)1
  • Routine use of blood products1
  • Debridement and fasciotomy1,4,5
  • Ice/cold packs on the affected area1,6
  • Prophylactic antibiotics1,7,8

When It Comes to Snake Envenomation, It Helps to Know Fact From Fiction

Expand each myth below to reveal more accurate facts about envenomation.

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You must identify the species of snake that bit the patient.

Fact: 98% of venomous snakebites in the United States are from North American pit vipers, including copperheads, cottonmouths, and rattlesnakes.9 CroFab is specifically designed to contain a spectrum of venom-specific protein (Fab) fragments targeting the range of complex toxins found in North American pit viper venoms.10 Therefore, treatment should not be delayed in an attempt to identify the species of snake that caused the envenomation.10

Copperhead bites are not dangerous.

Fact: Although copperhead envenomation is rarely fatal, it can result in substantial pain and impaired function lasting several weeks. In some cases limb dysfunction may last up to a year or more.11

Using nonsteroidal anti-inflammatory drugs (NSAIDs) is part of treatment for snakebites.

Fact: Because of the potential harm associated with platelet dysfunction caused by NSAIDs, the use of NSAIDs as part of treating snakebites is generally not recommended.1

Debridement and fasciotomy are appropriate treatment options for the snakebite patient.

Fact: With the widespread availability of safe antivenom, any form of debridement or fasciotomy is rarely needed and not beneficial to the patient.1,4,5

Applying ice or tourniquet will slow the venom progression.

Fact: Applying ice to a venomous snakebite appears to be ineffective. Aggressive cryotherapies (such as ice water immersion) are ineffective, as well, and have been associated with severe tissue injury.1,6 The use of tourniquets is also ineffective and potentially harmful when used to treat snakebite envenomations.1-3

Due to the puncture wound by the snakebite, antibiotics must be given.

Fact: The potential risk of antibiotics (i.e., allergic reactions, formation of drug-resistant bacteria) outweigh the benefit in the snakebite patient; therefore, use of antibiotics is not recommended. 1,7,8

To learn how experts recommend treating pit viper envenomation, view the Unified Treatment Algorithm.

Watch Dr. Arnold discuss why he considers
surgical intervention a last resort.

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Recommendations for
the management of 
North American pit viper 

Launch Treatment Algorithm
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Appropriate dosing achieves initial and sustained control
of envenomation2

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Real-world use supports improved outcomes
with CroFab2

Hear Real Patient Experiences

1. Lavonas EJ, Ruha AM, Banner W, et al. Unified treatment algorithm for the management of crotaline snakebite in the United States: results of an evidence-informed consensus workshop. BMC Emerg Med. 2011;11:2. 2. Amaral CF, Campolina D, Dias MB, Bueno CM, Rezende NA. Tourniquet ineffectiveness to reduce the severity of envenoming after Crotalus durissus snake bite in Belo Horizonte, Minas Gerais, Brazil. Toxicon. 1998;36(5):805-808. 3. Corbett B, Clark RF. North American Snake Envenomation. Emerg Med Clin North Am. 2017;35(2):339-354. 4. Domanski K, Kleinschmidt KC, Greene S, et al. Cottonmouth snake bites reported to the ToxIC North American snakebite registry 2013-2017. Clin Toxicol (Phila). 2020;58(3):178-182. 5. Toschlog EA, Bauer CR, Hall EL, Dart RC, Khatri V, Lavonas EJ. Surgical considerations in the management of pit viper snake envenomation. J Am Coll Surg. 2013;217(4):726-735. 6. Frank HA. Snakebite or frostbite: what are we doing? An evaluation of cryotherapy for envenomation. Calif Med. 1971;114(5):25-27. 7. Ruha AM, Kleinschmidt KC, Greene S, et al. The epidemiology, clinical course, and management of snakebites in the North American Snakebite Registry. J Med Toxicol. 2017;13(4):309-320. 8. LoVecchio F, Klemens J, Welch S, Rodriquez R. Antibiotics after rattlesnake envenomation. Emerg Med. 2002;23(4):327-328. 9. Gummin DD, Mowry JB, Beuhler MC, et al. 2019 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 37th Annual Report. Clin Toxicol (Phila). 2020;58(12):1360-1541. 10. CroFab®. Prescribing information. BTG International Inc.; August 2018. 11. Lavonas EJ Gerardo CJ; Copperhead Snakebite Recovery Outcome Group. Prospective study of recovery from copperhead snake envenomation: an observational study. BMC Emerg Med. 2015;15:9.