Pit Viper Snakebite Assessment and Treatment

Course #94111 - $60 -


This course provides information about snakes themselves, about the "bite," and how the venom affects organ systems and bodies as a whole. It also familiarizes the learner with the pit viper antivenoms available in the United States. From the field through follow-up after discharge from the hospital, step-by-step procedures encourage application of the standard of assessment and treatment, including separate procedures for patients arriving with no symptoms versus those who arrive with symptoms. This course is designed for use immediately at the bedside as well as for continuing education purposes.

Education Category: Infection Control / Internal Medicine
Release Date: 02/01/2023
Expiration Date: 01/31/2026

Table of Contents


This course is designed for physicians, nurses, and allied health professionals involved in the identification and care of patients who have been bitten by a snake.

Accreditations & Approvals

In support of improving patient care, NetCE is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. NetCE is accredited by the International Accreditors for Continuing Education and Training (IACET). NetCE complies with the ANSI/IACET Standard, which is recognized internationally as a standard of excellence in instructional practices. As a result of this accreditation, NetCE is authorized to issue the IACET CEU.

Designations of Credit

This activity was planned by and for the healthcare team, and learners will receive 10 Interprofessional Continuing Education (IPCE) credit(s) for learning and change. NetCE designates this enduring material for a maximum of 10 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. NetCE designates this continuing education activity for 10 ANCC contact hour(s). NetCE designates this continuing education activity for 2 pharmacotherapeutic/pharmacology contact hour(s). NetCE designates this continuing education activity for 12 hours for Alabama nurses. Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 10 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Completion of this course constitutes permission to share the completion data with ACCME. Successful completion of this CME activity, which includes participation in the evaluation component, enables the learner to earn credit toward the CME and/or Self-Assessment requirements of the American Board of Surgery's Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit. This activity has been designated for 10 Lifelong Learning (Part II) credits for the American Board of Pathology Continuing Certification Program. Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME's "CME in Support of MOC" program in Section 3 of the Royal College's MOC Program. AACN Synergy CERP Category A. NetCE is authorized by IACET to offer 1 CEU(s) for this program.

Individual State Nursing Approvals

In addition to states that accept ANCC, NetCE is approved as a provider of continuing education in nursing by: Alabama, Provider #ABNP0353, (valid through July 29, 2025); Arkansas, Provider #50-2405; California, BRN Provider #CEP9784; California, LVN Provider #V10662; California, PT Provider #V10842; District of Columbia, Provider #50-2405; Florida, Provider #50-2405; Georgia, Provider #50-2405; Kentucky, Provider #7-0054 through 12/31/2025; South Carolina, Provider #50-2405; West Virginia RN and APRN, Provider #50-2405.

Special Approvals

This activity is designed to comply with the requirements of California Assembly Bill 1195, Cultural and Linguistic Competency.

Course Objective

This course is designed to provide emergency and intensive care nursing and physician staff with an accurate, concise, and practical clinical guide to the evaluation and management of snakebite victims who present with North American pit viper envenomation.

Learning Objectives

Upon completion of this course, you should be able to:

  1. Identify snakes that may be venomous and the characteristics of snakebite.
  2. Outline the local and systemic effects of pit viper envenomation.
  3. Describe the characteristics of available antivenoms.
  4. Evaluate general approaches to the assessment of patients with snakebite.
  5. Discuss the role of blood products and urinary catheterization in patients being treated for snakebite.
  6. Discuss the prehospital management of the patient who has suspected or known snakebite.
  7. Devise a strategy for the management of asymptomatic patients with suspected or known snakebite.
  8. Describe the approach to management of symptomatic patients with suspected or known snakebite.
  9. Outline the reconstitution, dosages, and application of antivenom, including management of potential untoward effects.
  10. Analyze the appropriate follow-up of patients who were treated for snakebite, including indications to re-treat.


Jon E. Soskis, BSN, RN, is a retired expert in pit viper snakebite assessment and treatment. He earned his BS in Biology from Stetson University in DeLand, Florida, and his BSN from Florida State University in Tallahassee, Florida, while completing his EMT training at Tallahassee Community College. Following a 30-year practice in emergency nursing at Tallahassee Memorial HealthCare, including numerous in-hospital snakebite consultations, he remains available to the local medical and nursing community for consultation during active treatment of pit viper envenomation, and annually trains Florida State University College of Medicine surgical and internal medicine residents as well as Tallahassee Memorial HealthCare Family Practice residents in the subject. He has likewise presented at hospitals in Florida and North Carolina.

Mr. Soskis wishes to recognize the years-long contributions to this work by Rick Dart, MD, PhD, Director of Rocky Mountain Poison and Drug Center; Jeffrey Bernstein, MD, Medical Director of the South Florida Poison Information Center, Miami; and Ed Hall, MD, South Georgia Surgical Associates.

Faculty Disclosure

Contributing faculty, Jon E. Soskis, BSN, RN, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Division Planners

John M. Leonard, MD

Margo A. Halm, RN, PhD, NEA-BC, FAAN

Division Planners Disclosure

The division planners have disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Director of Development and Academic Affairs

Sarah Campbell

Director Disclosure Statement

The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

About the Sponsor

The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.

Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.

Disclosure Statement

It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.

Technical Requirements

Supported browsers for Windows include Microsoft Internet Explorer 9.0 and up, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Supported browsers for Macintosh include Safari, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Other operating systems and browsers that include complete implementations of ECMAScript edition 3 and CSS 2.0 may work, but are not supported. Supported browsers must utilize the TLS encryption protocol v1.1 or v1.2 in order to connect to pages that require a secured HTTPS connection. TLS v1.0 is not supported.

Implicit Bias in Health Care

The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.

Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.