Clinical Management of Copperhead vs. Rattlesnake Envenomation: A Comparative Case Study Lockyer J., White N. Berry A., Blankenship B., MD Department of Medical Education, Quillen College of Medicine, East Tennessee State University

Additional Authors

Noah White, Department of Medical Education, Quillen College of Medicine ETSU, Johnson City, TN. Andy Berry, Department of Medical Education, Quillen College of Medicine, ETSU, Johnson City, TN.

Abstract

Background Envenomation by Crotalinae snakes varies in severity based on venom composition, patient response, and treatments. This case study suggests that venom severity plays a more significant role in determining patient outcomes than early intervention alone. By comparing two cases of envenomation, we assessed different venoms on clinical progression. Patient 1 (Pt. 1): A 39-year-old male sustained a copperhead bite and presented with upper extremity pain and edema. Symptoms progressed slowly. He left AMA after pain management but returned due to worsening pain. He was admitted overnight for pain control and CroFab administration and improving and discharged the next day without complications. Patient 2 (Pt. 2): A 40-year-old male sustained a suspected rattlesnake bite (not confirmed). He presented with rapidly worsening pain and edema. Despite early pain management and CroFab, his condition deteriorated. He was transferred for higher-level care, developed significant lymphedema, infection, and complications following fasciotomy, with a possible need for limb amputation. Discussion Copperhead venom is cytotoxic, causing localized swelling, pain, and tissue damage, but is rarely life-threatening. Rattlesnake venom is hemotoxic and neurotoxic, leading to coagulopathy, systemic effects, and tissue necrosis. Pain control, wound surveillance, and CroFab administration are essential. However, early intervention in the rattlesnake bite did not prevent complications, while treatment delay in the copperhead did not worsen outcomes. Venom type appears to play a greater role than early management, as some rattlesnake bites still progress. Conclusion Findings suggest venom severity is a stronger determinant of outcomes. Rural EDs should develop standardized protocols based on venom type. Strengthening public awareness and improving patient education on AMA risks may reduce morbidity. Research should explore adjunctive treatments to enhance outcomes in envenomation cases.

Start Time

16-4-2025 1:30 PM

End Time

16-4-2025 4:00 PM

Presentation Type

Poster

Presentation Category

Health

Student Type

Clinical Doctoral Student (e.g., medical student, pharmacy student)

Faculty Mentor

Brock Blankenship

Faculty Department

Medical Education

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Apr 16th, 1:30 PM Apr 16th, 4:00 PM

Clinical Management of Copperhead vs. Rattlesnake Envenomation: A Comparative Case Study Lockyer J., White N. Berry A., Blankenship B., MD Department of Medical Education, Quillen College of Medicine, East Tennessee State University

Background Envenomation by Crotalinae snakes varies in severity based on venom composition, patient response, and treatments. This case study suggests that venom severity plays a more significant role in determining patient outcomes than early intervention alone. By comparing two cases of envenomation, we assessed different venoms on clinical progression. Patient 1 (Pt. 1): A 39-year-old male sustained a copperhead bite and presented with upper extremity pain and edema. Symptoms progressed slowly. He left AMA after pain management but returned due to worsening pain. He was admitted overnight for pain control and CroFab administration and improving and discharged the next day without complications. Patient 2 (Pt. 2): A 40-year-old male sustained a suspected rattlesnake bite (not confirmed). He presented with rapidly worsening pain and edema. Despite early pain management and CroFab, his condition deteriorated. He was transferred for higher-level care, developed significant lymphedema, infection, and complications following fasciotomy, with a possible need for limb amputation. Discussion Copperhead venom is cytotoxic, causing localized swelling, pain, and tissue damage, but is rarely life-threatening. Rattlesnake venom is hemotoxic and neurotoxic, leading to coagulopathy, systemic effects, and tissue necrosis. Pain control, wound surveillance, and CroFab administration are essential. However, early intervention in the rattlesnake bite did not prevent complications, while treatment delay in the copperhead did not worsen outcomes. Venom type appears to play a greater role than early management, as some rattlesnake bites still progress. Conclusion Findings suggest venom severity is a stronger determinant of outcomes. Rural EDs should develop standardized protocols based on venom type. Strengthening public awareness and improving patient education on AMA risks may reduce morbidity. Research should explore adjunctive treatments to enhance outcomes in envenomation cases.