UMEM Educational Pearls

Category: Toxicology

Title: Antivenin Only for North American Crotalinae Snake Envenomation

Keywords: copperhead, snake, envenomation, antivenin, crotalinae, fasciotomy (PubMed Search)

Posted: 1/7/2014 by Bryan Hayes, PharmD (Emailed: 1/9/2014) (Updated: 1/9/2014)
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Current evidence does not support the use of fasciotomy or dermotomy following North American Crotalinae envenomation with elevated intracompartmental pressures. [1]

A new case report of a 17-month old bitten by a copperhead snake reinforces that early and adequate administration of crotaline Fab antivenin is the treatment of choice. [2]

Many experts recommend against measuring compartement pressures altogether; we know it will be elevated.


  1. Cumpston KL. Is there a role for fasciotomy in Crotalinae envenomation in North America? Clin Toxicol 2011;49(5):351-65. [PMID 21740134]
  2. Mazer-Amirshahi M, et al. Elevated compartment pressures from copperhead envenomation succesfully treated with antivenin. J Emerg Med 2014;46(1):34-7. [PMID 23871482]

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