Q. A 58-year-old construction worker was working outside when he was bitten by a pygmy rattlesnake just below the thumb. In the emergency department, you note fang marks, erythema, and swelling up to the elbow. The patient feels nauseous. What is the most appropriate treatment?

A. Emergent fasciotomy 

B. Immediate administration of broad-spectrum antibiotics for cellulitis 

C. 10 vials of crotalidae polyvalent immune fab (CroFab)

D. Observation in the emergency department for 8 to 12 hours; if symptoms worsen, administer antivenom