North American Coral Snake Envenomation
North American coral snakes belong to the elapidae family. Medically significant North American coral snakes include M. fulvius fulvius (Eastern coral snake) and M. fulvius tener (Texas coral snake). They are famously known for their brightly banded black, red, and yellow pattern. Their bites are rare due to their docile nature and natural habitat. They may leave fang marks but their absence does not eliminate the possibility of envenomation. Neurotoxicity is the main feature of coral snake envenomations. It is mediated via blockade of presynaptic acetylcholine release as well as postsynaptic end-plate receptors. The major components of their venom are phospholipase A2 and 3 finger toxins. Symptoms of envenomation usually occur within 2 h and may involve slurred speech, cranial nerve palsies, bulbar paralysis, respiratory paralysis, and full flaccid paralysis. Prehospital treatment should focus on providing high-quality symptomatic and supportive care to the victim, focusing on airway, breathing, and circulation. Definitive treatment is North American Coral Snake Antivenin (NACSA) and should, optimally, be provided before the onset of symptoms. The dose is usually 3–5 vials. There is a small risk of allergic, anaphylactic, or anaphylactoid reactions. There have been no deaths reported when treatment is sought or sequelae of envenomation after recovery.
KeywordsAntivenin Envenomation Micrurus fulvius North American coral snake
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