Rattlesnake (Crotalineae) Bite Simulation

This educational activity is a high-fidelity, standardized-patient simulation designed to train learners in the evaluation and management of pit viper (Crotalinae) snake envenomation. Participants are presented with a patient who arrives with an acute rattlesnake bite to the hand and must synthesize clinical findings, laboratory data, and diagnostic reasoning to guide treatment decisions. The case can progress through multiple clinical branches—from localized swelling to severe systemic complications such as hypotension, anaphylaxis, and disseminated intravascular coagulation (DIC). Learners are expected to initiate appropriate first aid, obtain diagnostic studies, consult poison control, administer antivenom when indicated, and communicate effectively with consultants and care teams. The simulation also includes structured debriefing materials to support clinical reasoning and reinforce evidence-based management strategies.

Target Learners 

This simulation is appropriate for: 

• Emergency Medicine residents 

• Paramedics 

• Internal Medicine residents 

• Family Medicine residents 

• 3rd- or 4th-year medical students completing an Emergency Medicine rotation 

The activity is intended for learners developing competency in emergency assessment, toxicologic management, and interprofessional communication. 

Equipment Needed 

Simulation Environment 

• Simulation laboratory configured as an Emergency Department room 

• Medication dispensing area (e.g., Pyxis or equivalent) 

• Audio-visual control room 

• Debriefing space 

Personnel / Roles 

• Standardized patient (adult) 

• 1–3 participant physicians (learners) 

• Nurse role 

• Course Director (physician educator) 

• Simulation education specialist / technician 

Monitoring & Clinical Equipment 

• Virtual vital signs monitor 

• 3-lead ECG 

• Blood pressure monitoring 

• Pulse oximetry 

• Intravenous access supplies 

Supporting Materials 

• Snake image for identification 

• Laboratory studies (provided as ordered): 

• CBC 

• Chemistry panel 

• PT/PTT 

• Fibrinogen or D-dimer 

• Creatine kinase 

• Type & screen 

• ECG and chest X-ray (optional, if ordered) 

• Poison Control information sheet 

• Antivenom (CroFab) simulation materials 

• Moulage for bite wound (optional) 

Estimated Time to Complete 

Debriefing duration may be adjusted based on learner experience level and instructional goals.