蛇咬傷沒有出現毒性症狀處置

http://www.uptodate.com/contents/snakebites-worldwide-management

並非所有毒蛇咬傷都會被注入毒素, 病患如果沒有毒性症狀, 應在醫院觀察, 如果懷疑神經毒性, 應觀察 24 小時. 出血性蛇毒, 通常在 12 小時內會出現症狀 (超過 12 小時以上無出血性蛇毒症狀, 應該不是出血性的蛇毒)

如果當地毒蛇可能造成大量肌肉壞死, 應觀察 24 小時, 並在出院前測量 CK level

在醫療資源比較不容易取得的地方, 通常建議觀察一天, 隔天早上出院. 傍晚或半夜出院比較容易出問題. 

Asymptomatic (dry bite) — A significant proportion of snakebites do not result in envenomation. Patients without clinical features of local or systemic envenomation should be closely observed before discharge from medical attention. The time required for observation in hospital before discharge of an asymptomatic patient with possible envenomation depends upon the venom properties of the local snake fauna and the level of clinical and laboratory expertise available [25]. Clinicians who are unfamiliar with the management of snakebite should seek expert consultation with a clinical toxinologist, poison control center, or physician experienced in management of snakebites in the region. (See 'Additional resources' below.)

Important considerations include the following [15,16]:

●Patients with unknown snakebites in regions with neurotoxic snake species may warrant prolonged observation (up to 24 hours post-bite).

●Snake venoms that cause isolated coagulopathy will usually do so within 12 hours after envenomation.

●In locations where snakebite can cause systemic myolysis, observation up to 24 hours and pre-discharge measurement of creatine kinase may be warranted.

●In general, it is wise to observe suspected snakebite patients overnight, rather than discharge them in the evening or at night, as local resources allow.