Skip to main content
Open Access Publications from the University of California


UCLA Previously Published Works bannerUCLA

Unified treatment algorithm for the management of crotaline snakebite in the United States: results of an evidence-informed consensus workshop.

  • Author(s): Lavonas, Eric J;
  • Ruha, Anne-Michelle;
  • Banner, William;
  • Bebarta, Vikhyat;
  • Bernstein, Jeffrey N;
  • Bush, Sean P;
  • Kerns, William P;
  • Richardson, William H;
  • Seifert, Steven A;
  • Tanen, David A;
  • Curry, Steve C;
  • Dart, Richard C;
  • Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority
  • et al.


Envenomation by crotaline snakes (rattlesnake, cottonmouth, copperhead) is a complex, potentially lethal condition affecting thousands of people in the United States each year. Treatment of crotaline envenomation is not standardized, and significant variation in practice exists.


A geographically diverse panel of experts was convened for the purpose of deriving an evidence-informed unified treatment algorithm. Research staff analyzed the extant medical literature and performed targeted analyses of existing databases to inform specific clinical decisions. A trained external facilitator used modified Delphi and structured consensus methodology to achieve consensus on the final treatment algorithm.


A unified treatment algorithm was produced and endorsed by all nine expert panel members. This algorithm provides guidance about clinical and laboratory observations, indications for and dosing of antivenom, adjunctive therapies, post-stabilization care, and management of complications from envenomation and therapy.


Clinical manifestations and ideal treatment of crotaline snakebite differ greatly, and can result in severe complications. Using a modified Delphi method, we provide evidence-informed treatment guidelines in an attempt to reduce variation in care and possibly improve clinical outcomes.

Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.

Main Content
For improved accessibility of PDF content, download the file to your device.
Current View