Introduction

Enclosed are protocols and which have been written for potential snakebites to human beings.  The philosophy behind these protocols is very simple.  In the early days, there was a list of "experts" who might be summoned if a snakebite occurred.  It was rapidly learned that these experts were not always available.  This "hope an expert is available" system was replaced with the enclosed one, in which we assume that no expert is available.

These protocols are written so that any reasonable emergency room or trauma physician can manage a snakebite appropriately.  For every snake maintained in ones collection, one must keep or have access to antivenom in sufficient quantity to treat two "moderate" bites.  One should not rely on accessing antivenom from a zoo or regional poison control center, one must possess or have direct access to the appropriate antivenom for each and every exotic snake owned.  The exception to this in the United States is the rattlesnake, for antivenom for the rattlesnake is available in most hospitals and pharmacies in regions where rattlesnakes are indigenous.  This should be confirmed, however, never assumed.

The first step is to establish an evacuation system to a pre-arranged hospital.  Helicopter evacuation to a Level 1 Trauma Center is preferred, with paramedic ground transportation as a backup.  Telephone numbers and procedures should be carefully written, posted, and known to everyone involved.  The front sheet on each protocol must conform to each environment wherein exotic snakes are housed.  When a bite occurs no one thinks clearly, and the correct phone numbers, antivenom access, and evacuation system must be straightforward and operant.  Please modify these facesheets to correctly reflect your environment.  A system must be devised whereby a bitten victim is transported with the appropriate enclosed protocol.  These protocols contain information that will direct a reasonable physician to successfully treat indigenous or exotic snakebites.

If a person is bitten, the following should occur:

 1. The snake is safely contained.
 2.  The evacuation system is activated.
 3.  First aid is administered.
 4. The appropriate antivenom and treatment protocol are selected and transported to the hospital with the patient.

If additional assistance or advice is needed, it is recommended that you contact your local poison control center, or the San Diego Regional Poison Control Center at 800 876-4766.

Richard F. Clark, M.D.

Professor of Clinical Medicine

Director, UCSD Poison Control Center

Terence M. Davidson, M.D.

Professor of Surgery