Goto CS, Feng S. Crotalidae Polyvalent Immune Fab for the Treatment of Pediatric Crotaline Envenomation. Pediatric Emerg Care. Volume 25, Number 4, April 2009: 273-279

Children are among the most common victims of pit viper (crotalidae) envenomations. This article presents the indications and risk-benefit calculations for use of the newer sheep-derived polyvalent Fab antivenin for rattlesnake, copperhead and cottonmouth bites in young children.

Dosing is not weight-based, but adjusted to severity of clinical symptoms. Some copperhead bites with only local tissue injury may be observed without Fab use, but all patients with systemic findings should receive the antivenin, ideally within 6 hours of the bite.