ACMT Toxicology Visual Pearls: Exotic Viper Envenomation

exotic snake envenomation

A man was bitten twice on the dorsal radial aspect of his right hand while feeding his pet West African Bush Viper. The patient immediately tied multiple tourniquets around his right arm before presenting to the emergency department. During examination he is complaining of swelling and severe pain in his right upper extremity, but has no other complaints. What are the appropriate next steps in managing this patient?

  1. Apply ice to the bites
  2. Measure compartment pressures in the right arm and forearm
  3. Perform a fasciotomy
  4. Remove the tourniquets and order hematologic studies
  5. Use a venom extractor to reduce venom burden

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