Kobrabiss, (k)ein sonntäglicher Notfall

Exotic snake bite patients are a rarity for most European emergency doctors. The demands are extreme and very challenging for the emergency surgeon, who has only limited diagnostic resources and whose knowledge about the toxicology of snake poisoning is often insufficient. He is primarily dependent upon his senses for diagnosis. Most important is the treatment of the acute symptomatic. Basically the doctor must assess the patient immediately and prepare himself for the possible changes which can result from the actions of the toxin. In emergency medicine it is essential to evaluate the patient frequently. In addition, the well-known algorithms can be used at any time. The principal points include frequent evaluations to avoid hypoxia and hypovolemia caused by systemic anaphylaxis and hemorrhage. Early intubation can be life-saving. The transfer to an intensive care unit is an important factor determining the patient's survival. As soon as possible antivenin should be made available. The following case report describes the case of a private reptile breeder, who handled exotic snakes and was bitten by a Cobra.