1. Reptile Bites Chapter 195

2. Crotalinae (Pit Viper) Bites • Bilateral depressions or pits between and below the eye and nostril • Pit used to detect warm-blooded prey • Large fangs that fold against the roof of the mouth • Rattle snakes included

3. Diagnosis and Treatment • Local injury: fang marks • Coagulopathy: throbocytopenia and elevated PTT • Systemic effects: hypotension/tachycardia, metallic taste • Treatment mainstay: Antivenom (CroFab or FabAV) • Observe for at least 8hrs

4. Coral Snake (Elapid) • “Red on yellow, kill a fellow; Red on black, venom lack” • Voluntary control of venom injection “dry bite” • Symptoms may be delayed for 12hrs • Neurotoxic effects: seizures, salivation, fixed and dilated pupils, ptosis; death by respiratory failure

5. Australian Elapids Clinically: neurotoxic, cardiovascular depression, renal impairment, and procoagulant toxins (intracranial hemorrhage) Treat with antivenom Brown snake below causes rapid death

6. Cobra • Immediate pain at bite site • Followed by cranial n dysfunction, muscle weakness, and parasympathetic stimulation • Treat with antivenom • Observe for 24hrs • This snake can kill an Elephant with one bite!

7. Gila monster • Slow moving lizard in southwestern US • Similar to rattlesnake bite but do to lack of fangs requires prolonged bite • Requires force to remove reptile from bite site • Local wound care and supportive measures (board question)

8. Turtles • Once thought to be an innocent family pet…now known as a threat to society • Its only predator…Dr. Cardinal and a hammer