What is the appropriate medical management for coral snake bites?
• Notify the Poison Center immediately. All patients should be admitted to an ICU for 24 hours of observation due to possible delayed effects. • Keep patient NPO to prevent aspiration. • Establish a large-bore IV site and infuse a maintenance IV solution. • Update tetanus immunization if needed. • Apply cardiac monitor and pulse oximeter. Monitor vital signs and mental status every 30 minutes, especially respirations. • Obtain blood for CK level to monitor for myotoxic damage. • Perform baseline and serial peak flow spirometry every 2 hours. • Perform ABG immediately for respiratory distress, or decreasing peak flow or oxygen saturation measurements. • Avoid narcotics or sedatives which may mask neurologic effects and suppress respirations. • Immediately intubate and ventilate aggressively for signs of respiratory distress, hypoxia, altered mental status or seizures. • Antibiotics are generally not indicated. • DO NOT ADMINISTER CROFAB®.
