The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry

On Behalf Of The Toxic Snakebite Study Group

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

The American College of Medical Toxicology established the North American Snakebite Registry (NASBR), a national database of detailed, prospectively collected information regarding snake envenomation in the United States, in 2013. This report describes the epidemiology, clinical course, and management of snakebites in the NASBR. All cases entered into the NASBR between January 1, 2013 and December 31, 2015 were identified. Descriptive statistics are used to report results. Fourteen sites in 10 states entered 450 snakebites. Native species comprised 99% of cases, almost all of which were pit viper bites. 56.3% were identified as rattlesnakes and 29.4% as copperheads. 69.3% were male and 28.2% were children age 12 and under. Fifty-four percent of bites were on the lower extremity. Twenty-seven percent of patients with lower extremity bites were not wearing shoes. Common tissue findings associated with envenomation were swelling, ecchymosis, and erythema. Systemic effects and hematologic toxicity were more common in rattlesnake than copperhead or cottonmouth envenomations. Crotalidae Polyvalent Immune Fab antivenom was given to 84% of patients. Twelve patients (4.3%) were re-admitted to the hospital after completion of treatment. Eight were re-treated with antivenom. The NASBR gathers detailed data on venomous snakebites across the US. In its initial years, useful information has already been gained. Data regarding footwear will inform public health interventions and education, and information regarding the clinical presentation may help physicians better anticipate effects and manage snakebite. As the number of cases in the NASBR grows, associations between patient-related factors and outcomes may be studied.

Original languageEnglish (US)
Pages (from-to)1-12
Number of pages12
JournalJournal of Medical Toxicology
DOIs
StateAccepted/In press - Oct 3 2017

Fingerprint

Antivenins
Snake Bites
Epidemiology
Registries
Public health
Toxicity
Swelling
Agkistrodon
Education
Statistics
Tissue
Bites and Stings
Crotalus
Lower Extremity
Ecchymosis
Shoes
Erythema
Health Education
Toxicology
Public Health

Keywords

  • Antivenom
  • Envenomation
  • Snake
  • Snakebite

ASJC Scopus subject areas

  • Toxicology
  • Health, Toxicology and Mutagenesis

Cite this

The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry. / On Behalf Of The Toxic Snakebite Study Group.

In: Journal of Medical Toxicology, 03.10.2017, p. 1-12.

Research output: Contribution to journalArticle

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abstract = "The American College of Medical Toxicology established the North American Snakebite Registry (NASBR), a national database of detailed, prospectively collected information regarding snake envenomation in the United States, in 2013. This report describes the epidemiology, clinical course, and management of snakebites in the NASBR. All cases entered into the NASBR between January 1, 2013 and December 31, 2015 were identified. Descriptive statistics are used to report results. Fourteen sites in 10 states entered 450 snakebites. Native species comprised 99{\%} of cases, almost all of which were pit viper bites. 56.3{\%} were identified as rattlesnakes and 29.4{\%} as copperheads. 69.3{\%} were male and 28.2{\%} were children age 12 and under. Fifty-four percent of bites were on the lower extremity. Twenty-seven percent of patients with lower extremity bites were not wearing shoes. Common tissue findings associated with envenomation were swelling, ecchymosis, and erythema. Systemic effects and hematologic toxicity were more common in rattlesnake than copperhead or cottonmouth envenomations. Crotalidae Polyvalent Immune Fab antivenom was given to 84{\%} of patients. Twelve patients (4.3{\%}) were re-admitted to the hospital after completion of treatment. Eight were re-treated with antivenom. The NASBR gathers detailed data on venomous snakebites across the US. In its initial years, useful information has already been gained. Data regarding footwear will inform public health interventions and education, and information regarding the clinical presentation may help physicians better anticipate effects and manage snakebite. As the number of cases in the NASBR grows, associations between patient-related factors and outcomes may be studied.",
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