Unified treatment algorithm for the management of crotaline snakebite in the United States: results of an evidence-informed consensus workshop

Lavonas, Eric J.; Ruha, Anne‐Michelle; Banner, William; Bebarta, Vikhyat S.; Bernstein, Jeff; Bush, Sean P.; Kerns, William; Richardson, William H.; Seifert, Steven A.; Tanen, David A.; Curry, Steve C; Dart, Richard C.

doi:10.1186/1471-227x-11-2

Cited by 186 publications

(174 citation statements)

References 80 publications

(147 reference statements)

Supporting

Mentioning

169

Contrasting

Unclassified

Order By: Relevance

“…Viper envenomations typically cause tissue and hematologic toxicity, although neurologic symptoms can occur with some species. Anaphylaxis and shock also rarely occur [2]. Elapid envenomations, conversely, are characterized by neurologic toxicity [3].…”

Section: Introductionmentioning

confidence: 99%

Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry

et al. 2016

Self Cite

View full text Add to dashboard Cite

Introduction In the developing world, occupation has been identified as a risk factor for snake bite. Such an association has not been described in the USA. The objective of this study was to describe the epidemiology and clinical manifestations of occupational snake bite in patients reported to the ToxIC North American Snakebite Registry (NASBR). Methods This was a prospective case series of patients reported to the ToxIC NASBR between January 1, 2014 and November 5, 2015. Variables collected included snake species, patient demographics, date and location of exposure, occupation, bite location, clinical manifestations, and management. Results Of 180 adult snake bites reported, 25 (13.9 %; 95 % CI 9.2-19.8 %) were occupational in nature. Rattlesnake envenomations were common (80 %). Most snake bites (96 %) occurred in men. Occupations most associated with snake bite were landscaping (28 %) and working directly with snakes (24 %). Fifty-six percent of bites occurred in an outdoor work environment. Seventy-six percent of envenomations were to the upper extremities. Intentional interaction occurred in 40 % of cases, all of which sustained finger envenomations. No cases presented with apparent acute ethanol intoxication. Conclusions The majority of occupational snake bites occurred in men working outdoors and were unintentional injuries. Bites involving the upper extremity tended to result from intentional interactions. Acute ethanol intoxication did not appear to be involved with occupational envenomations.

show abstract

Section: Introductionmentioning

confidence: 99%

Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…[7] Although inflammation induced by snake envenomation often mimics infection, true bacterial cellulitis is uncommon, and only affects 3% of snakebites. [9] Tissues at the point of envenomation may be nonviable regardless of intervention. The adjacent zone consists of variably injured tissues that may recover if the process of inflammation is reduced.…”

Section: Discussionmentioning

confidence: 99%

Hyperbaric oxygen therapy improves outcome of snake envenomation: tertiary center experience

Mukundan¹,

Ambookan²,

Angappan³

2016

PAR

View full text Add to dashboard Cite

Aim: Snakebite injuries of the extremities are common in tropical India among those involved in farming and outdoor activities. These injuries often complicated by cellulitis, gangrene, regional lymphadenopathy, compartment syndrome, bleeding abnormalities, septicemia, hypotension, and disseminated intravascular coagulation, resulting in significant morbidity and mortality. The purpose of the study is to share our experience of hyperbaric oxygen (HBO) therapy in the management of snakebite injuries. Methods: All patients who were treated for snakebite injuries in our department between October 2012 and October 2013 were included in the study. Results: Out of a total 395 patients, 174 patients treated with anti-snake venom with a mortality of 17 posttreatment. Forty-four out of the 174 patients was in the pediatric age group. Out of the patients referred to our department, 23 presented with cellulitis, 7 with compartment syndrome and 17 for the management of soft tissue cover over the extremities. Of the 47 patients, 30 involved the lower extremity and rest involved the upper extremity. All patients were subjected to HBO therapy as an adjunct. Six patients required flap cover: cross finger flap (n = 2), anterolateral thigh free tissue transfer (n = 1), lateral supramalleolar flap (n = 1), groin flap (n = 1), and dorsal metacarpal artery flap (n = 1). There was no need for fasciotomy among the patients who suffered impending compartment syndrome. Conclusion: HBO therapy may reduce the incidence of fasciotomy and increase the effectiveness of plastic surgical modalities if administered early and may be used as a useful adjunct in the management of snake envenomation injury.

show abstract

“…This mainstay of therapy for crotalid snakebites is used for patients experiencing progressive local, hematologic, and systemic effects of envenomation [3]. Typically, 1 or 2 doses of 4 to 6 antivenom (CroFab®) vials are given to achieve initial control [4]. Three maintenance doses may be utilized to prevent recurrence of symptoms [4,5] and patients can be discharged 24 hours after initial control [4].…”

Section: Introductionmentioning

confidence: 99%

“…Typically, 1 or 2 doses of 4 to 6 antivenom (CroFab®) vials are given to achieve initial control [4]. Three maintenance doses may be utilized to prevent recurrence of symptoms [4,5] and patients can be discharged 24 hours after initial control [4].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prolonged Coagulopathy Following Rattlesnake Envenomation Responsive to Antivenom: A Case Report

Roberts¹

2017

Int Arch Clin Pharmacol

View full text Add to dashboard Cite

Unified treatment algorithm for the management of crotaline snakebite in the United States: results of an evidence-informed consensus workshop

Cited by 186 publications

References 80 publications

Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry

Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry

Hyperbaric oxygen therapy improves outcome of snake envenomation: tertiary center experience

Prolonged Coagulopathy Following Rattlesnake Envenomation Responsive to Antivenom: A Case Report

Contact Info

Product

Resources

About