Chart — Emergency Nursing
Envenomation & Sting Comparison Chart
Snakes, spiders, stings, and the sea — sorted by what the venom does, the hallmark sign, the key intervention, and the well-meaning “help” to avoid. Anaphylaxis from a sting is the most common killer here.
Educational use only. Antivenom and definitive care are provider- and poison-control-directed. Local species and protocols vary. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Side by Side
| Source | Venom effect | Hallmark signs | Key intervention | Avoid |
|---|---|---|---|---|
| Pit viper (rattlesnake, copperhead) | Hemotoxic/cytotoxic | Fang marks, severe swelling, bruising, coagulopathy, necrosis | Immobilize, mark swelling, antivenom (CroFab/Anavip) | Ice, tourniquet, incision/suction |
| Coral snake | Neurotoxic | Minimal local signs; DELAYED weakness, ptosis, dysphagia, respiratory failure | Observe (delayed), airway support, antivenom per protocol | Assuming a 'mild' bite is safe |
| Black widow | Neurotoxic | Severe muscle rigidity/cramping (abdomen mimics acute abdomen), sweating, hypertension | Pain control, muscle relaxants/benzos; antivenom if severe | Mistaking abdominal rigidity for a surgical abdomen |
| Brown recluse | Cytotoxic | Painful lesion → necrotic ulcer ('red, white & blue'); rarely systemic hemolysis | Wound care, observe, delayed debridement | Early aggressive excision |
| Bee / wasp sting | Allergic ± local | Local pain/swelling; ANAPHYLAXIS in allergic patients | Scrape out stinger; IM epinephrine for anaphylaxis | Squeezing the stinger; under-treating anaphylaxis |
| Jellyfish / marine | Venomous nematocysts | Linear painful welts; rarely systemic | Rinse with vinegar/seawater, remove tentacles, hot-water immersion | Fresh water (fires more nematocysts) |
Exam Traps
- ✦Pit viper = hemotoxic (antivenom); coral snake = neurotoxic with DELAYED onset (observe).
- ✦Black widow = neurotoxic cramping; brown recluse = cytotoxic necrotic ulcer.
- ✦Snakebite: NO ice, tourniquet, incision, or suction — immobilize and mark the swelling.
- ✦Sting anaphylaxis = IM epinephrine first; scrape (don't squeeze) the stinger.
- ✦Jellyfish: rinse with vinegar/seawater, NOT fresh water (fresh water discharges more venom).
Related Resources
Standards & sources
Fact-checked Jun 20, 2026This page is written to align with Emergency Nurses Association (ENA) · AHA ACLS / PALS Guidelines · Advanced Trauma Life Support (ATLS). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →