title: Snakebite treatment at a southeastern regional referral center.
abstract: Our objective was to determine the prevalence of poisonous snakebite victims admitted to a regional trauma center in Southeastern Georgia over a 10-year period, as well as the type of snake, grade of envenomation, treatment administered, morbidity and mortality, and outcome. Records of patients admitted to the center for snakebite from a 24-county catchment area during the 10-year period (January 1984 to January 1994) were retroactively reviewed. Sixty-three (63) bites in 62 victims of venomous snakebites were treated. The snake distribution was rattlesnake: 19 (30%), copperhead: 18 (29%), cottonmouth moccasin: 8 (12%), unknown: 18 (29%). Envenomation grades were Grade I: 20 (32%), Grade II: 24 (38%), Grade III: 10 (16%), and Grade IV: 9 (14%). Fourteen of 19 (74%) Grades III and IV envenomations were from rattlesnakes. Antivenin was used in all Grade IV and half of the Grade III envenomations. Antivenin was administered within 3 hours of injury in all but one case. Five patients had surgery. Two patients (both Grade I) developed anaphylaxes from antivenin given before hospitalization. All patients recovered. An average of 6 snakebites were treated each year. Expeditious transport, attention to the type of snake inflicting the bite, and judicious use of antivenin will result in a favorable outcome for the snakebite victim.
authors.affiliation: Department of Surgical Education, Memorial Medical Center, Savannah, Georgia 31403-3089, USA.
authors.forename: R
authors.initials: R
authors.lastname: Rudolph
authors.forename: G E
authors.initials: GE
authors.lastname: Neal
authors.forename: J S
authors.initials: JS
authors.lastname: Williams
authors.forename: A P
authors.initials: AP
authors.lastname: McMahan
mesh_terms: D000328:Adult; D017836:Agkistrodon; D000818:Animals; D000997:Antivenins / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D017839:Crotalus; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D012017:Referral and Consultation; D012189:Retrospective Studies; D012909:Snake Bites / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000997:Antivenins