James M Abbey1, Nabil A Jaffar2, Hazem L Abugrara1, Muhammad Nazim2, Roger D Smalligan1, Faisal A Khasawneh3. 1. a 1 Department of Internal Medicine, Texas Tech University Health Sciences Center , Amarillo, TX, USA. 2. b 2 Department of Surgery, Texas Tech University Health Sciences Center , Amarillo, TX, USA. 3. c 3 Department of Internal Medicine, Divison of Pulmonary and Critical Care Medicine, Texas Tech University Health Sciences Center , Amarillo, TX, USA.
Abstract
INTRODUCTION: Numerous snakebites are reported every spring and summer in the United States especially in the Southwestern part of the country. This is usually associated with significant morbidity but fatalities are rare. Most victims are male and the majority of bites are on the extremities. METHODS: A search for all cases coded with a discharge diagnosis of snakebite injury revealed 90 patients admitted to Northwest Texas Hospital, the trauma center in Amarillo, Texas, between January 2002 and December 2012. These charts were retrospectively reviewed and data extracted including patient demographics, severity of snakebite, treatment given, and ultimate outcome. RESULTS: Ninety patients were admitted to the hospital due to snakebite. It was a rattlesnake in 83 cases. The mean age of the victims was 29.7 years and 74 of them were male. Fifty-one bites were on the upper extremities, thirty-eight bites were on the lower extremities and one bite was on the abdominal wall. About 95% of the lower extremity bites were moderate or severe compared to 74.5% of the upper extremity bites, Cramer's coefficient 0.3, p=0.02. Thirty-one patients had complications and twenty patients required surgical intervention. Eighty-eight patients received a median of 10 vials of antivenin that was well tolerated. Median hospital length of stay was 3 days. None of the patients died. CONCLUSION: Rattlesnake bites cause significant morbidity although mortality is rare. Early administration of antivenin and appropriate supportive measures and monitoring for complications with surgical intervention when needed leads to improved patient outcomes.
INTRODUCTION: Numerous snakebites are reported every spring and summer in the United States especially in the Southwestern part of the country. This is usually associated with significant morbidity but fatalities are rare. Most victims are male and the majority of bites are on the extremities. METHODS: A search for all cases coded with a discharge diagnosis of snakebite injury revealed 90 patients admitted to Northwest Texas Hospital, the trauma center in Amarillo, Texas, between January 2002 and December 2012. These charts were retrospectively reviewed and data extracted including patient demographics, severity of snakebite, treatment given, and ultimate outcome. RESULTS: Ninety patients were admitted to the hospital due to snakebite. It was a rattlesnake in 83 cases. The mean age of the victims was 29.7 years and 74 of them were male. Fifty-one bites were on the upper extremities, thirty-eight bites were on the lower extremities and one bite was on the abdominal wall. About 95% of the lower extremity bites were moderate or severe compared to 74.5% of the upper extremity bites, Cramer's coefficient 0.3, p=0.02. Thirty-one patients had complications and twenty patients required surgical intervention. Eighty-eight patients received a median of 10 vials of antivenin that was well tolerated. Median hospital length of stay was 3 days. None of the patients died. CONCLUSION: Rattlesnake bites cause significant morbidity although mortality is rare. Early administration of antivenin and appropriate supportive measures and monitoring for complications with surgical intervention when needed leads to improved patient outcomes.
Authors: Anne-Michelle Ruha; Kurt C Kleinschmidt; Spencer Greene; Meghan B Spyres; Jeffrey Brent; Paul Wax; Angela Padilla-Jones; Sharan Campleman Journal: J Med Toxicol Date: 2017-10-03
Authors: Caroline E Freiermuth; Eric J Lavonas; Victoria E Anderson; Kurt C Kleinschmidt; Kapil Sharma; Malin Rapp-Olsson; Charles Gerardo Journal: West J Emerg Med Date: 2019-04-26