Coral Snakes

If you encounter a coral snake bite you should immediately contact Poison Control at 1-800-222-1222 and follow their protocol for treatment.

Coral snakes ARE NOT pit vipers, but are members of the cobra family Elapidae. While venom of the pit vipers have both hematotoxic and neurotoxic effects, the venom of the coral snake has only neurotoxic effects, killing by paralyzing respiratory muscles and starving the prey of oxygen. Consequently, DO NOT APPLY the methods of assessment and treatment found in the text, Pit Viper Snakebite Assessment and Treatment – Applying the Standard, to bites of the coral snakes, but immediately call the above number for guidance. The poison control system has knowledge of where to most expeditiously obtain the proper antivenom.

“Red-on-Yellow, Kill-a-Fellow”

“Red-on-Yellow, Kill-a-Fellow” refers to the color pattern of the coral snake... Red color-bands touch yellow color-bands. A rare albino coral snake may be encountered, but a pattern can still be identified, if relatively faintly. The scarlet king snake and the scarlet snake, which look generally similar to the coral snake, have a pattern of red on black. The coral snake has a black colored nose, while the scarlet king and scarlet snake have red noses. The coral snake is slender and has round pupils as opposed to the pit vipers’ heavier bodies and elliptical pupils. Also, the coral snake does not have the triangular shaped head that is a characteristic of the pit viper.

Coral snake venom effects are known to be difficult to reverse once present, so treatment is initiated as soon as evidence of a bite by this snake presents itself. The bite can be difficult to detect, as they are very small, thus good lighting and magnification should be employed during examination of the suspected area of the bite. Intradermal normal saline can be injected into the suspect area as well, while looking for a tell-tale leak nearby, indicating a puncture wound. A scratch by this snake’s fangs could be significant. Chewing is not necessary for the coral snake to envenomate the victim. Time is important, so the victim should be transported immediately but safely to an emergency room. As coral snake bites make up only around 1% of all poisonous snakebites in the United States, the victim should insist that Poison Control be consulted unless under the care of a certified toxicologist.

Antivenin (Micrurus fulvius), Wyeth is no longer being manufactured in the United States; however, it is still available at some hospitals as the FDA has extended the expiration date beyond the original expiration date. This antivenom is ONLY effective against the poison of the American coral snakes (genus Micrurus) and not against the poison of the Arizona and Sonoran coral snakes (genus Micruroides).

CORALMYN antivenom is produced in Mexico by Instituto Bioclon and is effective against all American coral snake species. It is available through the Miami-Dade Fire Rescue Antivenin Bank, which is permitted by the FDA to import it; however, they are not permitted to distribute it, but they arrange to quickly deliver it for active cases.

Coral snake species and subspecies found in the United States (based on the master list of The Center for North American Herpetology):

The Book
“Bites on the highly vascular face and neck, while rare, are likely to require prompt intubation to protect the airway as the region swells.”