Slaying the Serpent: Pearls and Pitfalls of Crotalid Envenomations

Crotalid envenomations pose a significant clinical challenge for emergency medicine physicians, largely due to the potential for severe local toxicity, extensive tissue damage, and even systemic toxicity. This case report reviews the clinical presentation and anti-venom management of a patient who presented to our local emergency department after sustaining a crotalid envenomation to the left hand. Our case highlights common pitfalls in emergency management, including the non-interchangeability of dosing for available North American antivenoms. We briefly discuss the comparative efficacy of the two available North American antivenoms, CroFab® (BTG International, Inc., West Conshohocken, PA) and Anavip® (Rare Disease Therapeutics, Inc., Poway, CA).