THE CLINICAL CASE Over the summer, I was working at a rural hospital in Alabama as the hospitalist Program Director and as a bedside hospitalist. One day, the emergency room called to alert me that they had just examined a patient who had been bitten by a rattlesnake on his toe. According to the ER team, the patient did not meet anti-venom criteria, but they suggested he be monitored overnight anyway. A red flag went up; I had never dealt with a rattlesnake bite. I immediately went to UpToDate to read the latest guidelines and review the treatment algorithm DIAGNOSIS AND TREATMENT Based on what the ER had described and what I’d read in UpToDate, I suspected the patient might meet the criteria for anti-venom treatment.

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