snakebite [AS, snacan, to creep, bitan] , a wound resulting from penetration of the flesh by the fangs or teeth of a snake. Bites by snakes known to be nonvenomous are treated as puncture wounds; those produced by an unidentified or poisonous snake require immediate attention. The bitten area should be immobilized below heart level, the patient kept still, and prompt transportation arranged to an emergency department. Only polyvalent antivenin is available for bites of all pit vipers, including rattlesnakes, copperheads, and cottonmouths. Pit vipers are responsible for 98% of the poisonous snakebites in the United States. Bites of pit vipers are characterized by pain, redness, and edema followed by weakness, dizziness, profuse perspiration, nausea, vomiting, or weak pulse; subcutaneous hemorrhage; and, in severe cases, shock. Treatment may include the use of antivenin, analgesics, antibiotics, and antitetanus prophylaxis to prevent infections from pathogens found in the mouths of snakes. Patients sensitive to horse serum in antivenin may require antihistamines and steroids for the control of hives, urticaria, and other allergic reactions. Coral snakes rarely bite, but their venom contains a neurotoxin that can cause respiratory paralysis. Antivenin and respiratory support may be indicated.
