Hailing from the Pacific Northwest, where snakes are common, but not a health hazard, I rarely think about the possibility of snakebite emergencies. Now, living in Tennessee, things are different. There are a number of venomous snakes indigenous to the United States. Summertime, when outdoor activities, like wading in creeks and working in fields is common, snakes do pose a potentially serious danger. The other day while I was working in the emergency department, a patient arrived with the first serious snakebite we have seen this summer, prompting me to brush up on my envenomation know-how.