Wilderness Medical Society Practice Guidelines for the Treatment of Pitviper Envenomations in the United States and Canada

Pitviper envenomations can cause significant morbidity and mortality and must be treated with prompt evidence-based management protocols. Crotaline envenomations often produce local tissue injury and swelling and may result in systemic effects (including coagulopathy, neu-rotoxicity, or hypotension), the progression of which can be halted with prompt administration of antivenom. More severe envenomations feature extensive local effects and life-threatening systemic derangements that require repeated dosing of antivenom and closely monitored supportive care. Frequent patient assessment and diligent tracking of progressive signs and abnormal laboratory results are important for appropriate snakebite management. Consulting a toxinologist or poison control center can greatly assist in patient management. Finally, these guidelines are for crotaline snakes in the United States and Canada, and cannot be safely extrapolated to other snakes species or geographic regions. © 2015 Wilderness Medical Society.