Annually, more than 3,000 patients seek care in the United States following envenomation by poisonous snakes. Many of these envenomations are from Crotalinae such as rattlesnakes, cottonmouths, and copperheads, which mainly cause local tissue injury as opposed to a minority of bites from the Elapidae or coral snake which causes neuromuscular weakness leading to respiratory arrest. In October 2010, the American Heart Association and the American Red Cross issued their most recent first aid guidelines.