199-Snake Bites with Dr Evan Baines

This month, CoROM Conversations is joined by Dr Evan Baines, Emergency Medicine Physician, EMS Fellow, former 18D, and contributor to the JTS Snake Envenomation Clinical Practice Guideline (CPG).Snake envenomation remains a major global health problem, with millions of bites occurring annually and a disproportionate burden falling on remote and resource-limited regions. In this episode, Dr Evan Baines discusses the development of the JTS Snake Envenomation CPG, practical field management, antivenom selection, operational planning, and common misconceptions surrounding snakebite treatment.Chapters00:00 – Introduction to Snake Envenomation01:45 – Why Snake Bites Matter in Austere Medicine04:00 – Snakebite Myths and Immediate First Aid05:00 – The Four Envenomation Syndromes08:00 – Operational Planning and Antivenom Selection11:20 – Understanding the JTS Treatment Algorithms16:00 – Case Study: Pit Viper Envenomation22:00 – Determining When Antivenom Has Worked24:00 – Antivenom Dosing Principles26:00 – Field Diagnostics and Coagulopathy Assessment28:00 – Neurotoxic Snake Bites and Respiratory Failure33:00 – Why Identifying the Snake Often Doesn't Matter34:00 – Dry Bites and Return-to-Duty Decisions36:00 – Antivenom Reactions and Anaphylaxis Management39:00 – Tourniquets, Pressure Bandages, and Controversies46:00 – Life Over Limb? Risk-Benefit Decision Making51:00 – Airway Management in Neurotoxic Envenomation55:00 – Regulatory Challenges and Deployment Considerations57:45 – Key Take-Home Messages