title: Treating the snakebitten child in North America: a study of pit viper bites.
abstract: OBJECTIVE
  Snakebite envenomation is a potentially life-threatening form of trauma, the dangers of which are amplified in children because their smaller size increases the relative dose of venom received. The authors reviewed a large series of snakebitten children to address the medical and fiscal issues of treating these patients.
  
  
  METHODS
  The records of 37 snakebitten children (1987 through 1997) were analyzed for demographic data, signs of envenomation, use of specific therapies (antivenin, blood products, or surgery), length of hospitalization, complications, and cost of care.
  
  
  RESULTS
  Fifty-four percent of the children had a major envenomation demonstrated by systemic symptomatology, laboratory analysis, or need for surgery. All children made full recoveries with most receiving only supportive care (92%). The average time to emergency department presentation was 8 hours, where all children with major envenomations and those requiring specific therapies (surgery, clotting factors) were identified. Cost analysis showed an average of $2,450 dollars per child with the majority of expenses attributable to length of hospitalization.
  
  
  CONCLUSIONS
  Most snakebitten children completely recover with minimal supportive care, and they can be cared for safely and cost effectively as outpatients if no signs of major envenomation are noted within 8 hours of the bite.
authors.affiliation: Department of Surgery, University of Oklahoma College of Medicine, Children's Hospital of Oklahoma, Oklahoma City 73126, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Lopoo
authors.forename: J F
authors.initials: JF
authors.lastname: Bealer
authors.forename: P C
authors.initials: PC
authors.lastname: Mantor
authors.forename: D W
authors.initials: DW
authors.lastname: Tuggle
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000818:Animals; D000997:Antivenins / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009656:North America / Q000453:epidemiology; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D012909:Snake Bites / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D013514:Surgical Procedures, Operative / Q000379:methods; D017819:Viperidae
chemical_list: D000997:Antivenins