Coral snake envenomation

B. Elapidae. Coral snake envenomation is rare because of the snake s small mouth and fangs. The snake must hold on and chew the extremity for several seconds or more to work its fangs into the skin. 

For coral snake envenomation, consult a regional poison control center ([800] 222-1222) or an experienced medical toxicologist to determine the advisability of Micrurus fulvius antivenin (see p 410). In general, if there is evidence of coagulopathy or neurologic toxicity, administer antivenin. 

This family includes coral snakes, cobras, mambas, and kraits. In the United States, Elapidae are responsible for 1-2% of poisonous snakebites. The incidence of envenomations is greater in some other parts of the world. Examples of coral snakes commonly found in the United States are the eastern coral snake, the Sonoran coral snake, and the Texas coral snake. Coral snakes are smaller than pit vipers. They do not have facial pits, and the head is rounded, as are the pupils. Eangs are 2mm and fixed to the jaw. Coral snakes are also more brightly colored, with bands of black and red, separated by yellow and white bands. Coral snakes are timid, nocturnal creatures. 

Envenomation from a coral snake exerts minimal local pain, and appears as rows of teeth marks. Victims may report that the snake was chewing on the bite site and had to be forcibly removed. Coral snake venom is composed of peptides and enzymes that have not all been identified, but which exert neurotoxicity rather than cytotoxicity. 

Kitchens CS and Van Mierop LHS (1987) Envenomation by the Eastern coral snake (Micrurus fulvius fulvius) a study of 39 victims. Journal of the American Medical Association 258 1615-1618. 

Elapidae Micrurus Naja Bungarus Dendroaspis Coral snake Cobra Krait Mamba Human envenomation difficult because of small mouth and small fixed fangs in rear of mouth. Neurotoxicity usually predominates. 

A. Envenomation by the eastern coral snake (M fulvius) or the Texas coral snake M fulvius tenere). 

B. May not be effective for envenomation by the western, Arizona, or Sonora coral snake (M euryxanthus). 

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