Podcast # 343: Snake Bites

Educational Pearls:

  • Snake bites commonly occur between April and October.
  • Rattlesnake bites are the most common.
  • Venom contains proteins/enzymes that cause local inflammation, coagulopathy, and systemic effects (hypotension, angioedema, renal failure, etc.) along with neurotoxins may cause fasciculations, ptosis, drooling, or hyporeflexia.
  • Management:
  • Mark site for swelling.
  • Monitor progression.
  • Elevate and immobilize injured limb and treat pain.
  • Check basic labs including coagulation studies, and update tetanus.
  • Antidote is CroFab and use if patient has systemic symptoms.  Anaphylaxis is a known complication of CroFab
  • Avoid: ice, tourniquets, and incision and drainage.

 

References

Hifumi T et. al.. Venomous snake bites: clinical diagnosis and treatment. J Intensive Care. 2015 Apr 1;3(1):16. doi: 10.1186/s40560-015-0081-8.

Warrell DA. Snake bite. Lancet. 2010. 375(9708):77-88. doi: 10.1016/S0140-6736(09)61754-2.

Warrell DA. Envenoming and injuries by venomous and nonvenomous reptiles worldwide. In: Wilderness Medicine, 6th Edition, Auerbach PS (Ed), Elsevier Mosby, Philadelphia 2012. p.1040.

Podcast #283: Snow Blindness

Author:  John Winkler, M.D.

Educational Pearls

  • Photokeratitis is a UV burn of the sclera and cornea, which can cause blindness.
  • UV light causes eyelid swelling with diffuse scarring of the eye (widespread, punctate uptake of fluorescein dye). While this can eventually heal, it is incredibly painful.
  • Snow reflects light underneath sunglasses, so wrap-around goggles are the best form of prevention.
  • This can happen to welders, sunbathers or any other person with prolonged UV light exposure. 

References: https://emedicine.medscape.com/article/799025-treatment