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In the state of Maryland, the most common venomous snake is the copperhead. Though not as dangerous as the rattlesnake, it can still cause loss of function of limb and mortality in the pediatric patient.
Treatment has involved the use of CroFab (Protherics, Atlanta). This ovine derived monovalent immunoglobolin is actually made against the following snakes:
- Eastern diamondback rattlesnake
- Western diamondback rattlesnake
- Mojave rattlsnake
- Cottonmouth (Water moccasin)
Though efficacy has been shown with these snakes, we are hoping for cross-reactivity when we treat copperheads. There are case series and case reports (1) that have shown anectdotal improvement. We are still awaiting a real randomized controlled trial - may never happen.
References
Lavonas EJ, Gerardo CJ, O'Malley G, Arnold TC, Bush SP, Banner W Jr, Steffens M, Kerns WP 2nd.
Ann Emerg Med. 2004 Feb;43(2):200-6.