Question 1

A child experiences a snake bite while camping and is seen in the emergency department. The child's parents are not able to identify the type of snake. An inspection of the site reveals two puncture wounds on the child's arm with no swelling or erythema at the site. The child has normal vital signs. Which treatment is indicated?

A) Administering antivenom and observing the child for 24 to 48 hours
B) Cleaning the wound, giving tetanus prophylaxis, and observing for 12 hours
C) Performing a type and cross match of the child's blood
D) Referral to a surgeon for incision and suction of the wound

B

Accepted Answer

Based on the information provided, the lack of swelling or erythema at the site and the child's normal vital signs suggest a non-venomous bite or a dry bite (venom was not injected). Therefore, the treatment should focus on wound care and tetanus prophylaxis, with observation for 12 hours to monitor for any potential delayed onset of symptoms. Administering antivenom would not be indicated without a known venomous snake bite, and referral to a surgeon for incision and suction of the wound would not be necessary in this case. Performing a type and cross match of the child's blood would also not be necessary at this time.

Question 2

A patient is seen in the emergency department after experiencing a spider bite. The spider is in a jar and is less than one inch in size, yellow-brown, and has a violin-shaped marking on its back. Depending on the patient's symptoms, which treatments and diagnostic evaluations may be ordered? (Select all that apply.)

A) Airway management b. An acute abdominal series
C) Antivenom therapy
D) CBC, BUN, electrolytes, and creatinine
E) Coagulation studies
F) Tetanus prophylaxis

D, E, F

Accepted Answer

The spider described is likely a brown recluse spider, which can cause tissue damage and coagulation abnormalities. Therefore, a CBC, BUN, electrolytes, creatinine, coagulation studies, and tetanus prophylaxis are indicated. Antivenom therapy is not typically used for brown recluse spider bites. Airway management and an acute abdominal series would not be indicated for this type of spider bite.

Deck 24: Bites and Stings