Snakebite poisoning in children--a call for unified clinical guidelines.
In Israel, there are no uniform guidelines for the treatment policy of children snake-bitten by the Vipera palaestinae, the most abundant venomous snake in the country. We conducted a retrospective study aiming to compare treatment policies in two different medical centers. We found significant differences regarding admission and steroid administration criteria. Although the differences between the centers regarding anti-venom administration did not reach statistical significance, there were substantial differences. Neither of the centers had a well-established policy for the treatment of snake envenomation in children. In the era of cost containment, a policy of routine admission of children to the PICU service following V. palaestinae envenomation is unjustified, especially since the introduction of a specific monovalent anti-venom into the therapeutic armamentarium.
Ben Abraham
R
R
Department of Pediatric Intensive Care, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Winkler
E
E
Eshel
G
G
Barzilay
Z
Z
Paret
G
G
D000293:Adolescent; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000997:Antivenins / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012909:Snake Bites / Q000453:epidemiology / Q000628:therapy*; D013256:Steroids; D013997:Time Factors; D014757:Viper Venoms; D017819:Viperidae
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000997:Antivenins; D013256:Steroids; D014757:Viper Venoms