This came up in class (SFMS) and our PA cadre told us that at this years SOMA Conference the consensus was still observation/supportive care until the the pt can recieve definitive tx at a fixed facility.
According to that same conversation, as many of 30% of the bites of North American pit-vipers are non-envenomating - so observation for s/s prior to beginning an antivenin regimen is called for as a precaution against hypersensitivity rxn.
FWIW
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El Diablo sabe mas por viejo que por diablo.
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