Reference — Emergency Nursing
Snakebite & Spider Bite Reference
The venoms sort themselves into two buckets — those that destroy tissue and clotting, and those that hit nerves and muscle. Match the creature to the venom type and the management follows; just don’t reach for the field remedies that make it worse.
Educational use only. Antivenom and definitive management are provider- and poison-control-directed. Identification should never delay care or risk a second bite. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Snakes
| Type | Venom | Signs | Treatment |
|---|---|---|---|
| Pit vipers (rattlesnake, copperhead, cottonmouth) | Hemotoxic/cytotoxic | Fang marks, severe local pain/swelling/ecchymosis, coagulopathy/bleeding, tissue necrosis | Antivenom (CroFab/Anavip) for progression; supportive care |
| Coral snake ("red on yellow, kill a fellow") | Neurotoxic | Minimal local signs; DELAYED neuro effects — ptosis, dysphagia, weakness, respiratory failure | Observe (effects delayed); antivenom/airway support per protocol |
Snakebite — Do’s & Don’ts
Do
- ✓Keep the patient calm and still
- ✓Immobilize the limb at heart level (elevate in-hospital per protocol)
- ✓Remove rings/constricting items early
- ✓Mark the swelling edge with the time
- ✓Get to care; consult poison control; give antivenom as ordered
Don’t
- ✕Apply ice
- ✕Apply a tourniquet
- ✕Incise the wound or use suction
- ✕Apply electric shock
- ✕Waste time trying to catch/kill the snake
Spiders
| Type | Venom | Signs | Treatment |
|---|---|---|---|
| Black widow | Neurotoxic (alpha-latrotoxin) | Painful muscle rigidity/cramping (abdomen mimics acute abdomen), sweating, hypertension, restlessness | Pain control, muscle relaxants/benzodiazepines; antivenom for severe; supportive |
| Brown recluse | Cytotoxic | Initially mild, then a painful lesion → 'red, white & blue' → possible NECROTIC ulcer; rarely systemic (hemolysis) | Wound care, observation, delayed debridement; antivenom not standard |
NCLEX Pearls
- ✦Pit viper = hemotoxic (swelling, bleeding, necrosis) → antivenom; coral snake = neurotoxic with DELAYED onset → observe + support.
- ✦Snakebite: immobilize at heart level (elevate in-hospital), remove rings, mark and time swelling; NO ice, tourniquet, incision, or suction.
- ✦Black widow = neurotoxic muscle rigidity/cramping (can mimic acute abdomen); brown recluse = cytotoxic necrotic ulcer.
- ✦Don't risk a second bite trying to identify the snake — describe it instead.
- ✦Watch a swelling bitten limb for compartment syndrome; monitor pit-viper coagulation studies.
Related Resources
Standards & sources
Fact-checked Jun 20, 2026This page is written to align with Emergency Nurses Association (ENA) · AHA ACLS / PALS Guidelines · Advanced Trauma Life Support (ATLS). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →