Crotalid envenomation

The Southern Arizona experience

J. T. Tokish, James B. Benjamin, Frank G Walter

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective: To review a regional experience with the treatment of snakebites. Setting: Five major southern Arizona hospitals, including two Level I trauma centers. Design: A review of all snakebite admissions over a five-year period was performed. Results: During the period reviewed, 164 patients were admitted for snakebites. Rattlesnakes were responsible for 98 percent of identified envenomations. Thirty-six percent of the patients were transported by air to the admitting facility. Eighty percent of patients were admitted to the intensive care unit for an average of 1.6 days. Total hospital stays averaged 2.8 days. Ninety percent of patients received antivenin, usually only on the day of admission. Of those receiving antivenin, 20 percent had an anaphylactoid reaction, and 1 percent required readmission for serum sickness. Laboratory evaluation indicated abnormalities in platelet count, coagulation parameters, and fibrinogen levels, but these rarely required treatment. Thirteen percent of patients underwent surgical intervention, including a 4 percent fasciotomy rate, and a single amputation. Conclusion: The use of field treatment, including "cut and suck," tourniquets, and cryotherapy, increased the likelihood of surgery. The authors concluded that the intensive care unit and helicopter transport system were overused. They recommend that established objective envenomation severity scores be used to dictate patient treatment, specifically the use of antivenin.

Original languageEnglish (US)
Pages (from-to)5-9
Number of pages5
JournalJournal of Orthopaedic Trauma
Volume15
Issue number1
StatePublished - Jan 2001

Fingerprint

Viperidae
Antivenins
Snake Bites
Intensive Care Units
Serum Sickness
Crotalus
Tourniquets
Cryotherapy
Aircraft
Trauma Centers
Therapeutics
Platelet Count
Amputation
Fibrinogen
Length of Stay
Air

Keywords

  • Crotalid envenomation
  • Snakebite
  • Southern Arizona

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Crotalid envenomation : The Southern Arizona experience. / Tokish, J. T.; Benjamin, James B.; Walter, Frank G.

In: Journal of Orthopaedic Trauma, Vol. 15, No. 1, 01.2001, p. 5-9.

Research output: Contribution to journalArticle

Tokish, J. T. ; Benjamin, James B. ; Walter, Frank G. / Crotalid envenomation : The Southern Arizona experience. In: Journal of Orthopaedic Trauma. 2001 ; Vol. 15, No. 1. pp. 5-9.
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