Kingsnake.com
Sean P. Bush, MD, FACEP of Animal Planet's Venom ER
Venom Treatment and Field Research
February 28, 2006

PHFaust: On behalf of Jeff Barringer and all of us at kingsnake.com, I'm very pleased to welcome Dr. Sean Bush to our Eighth Annual Chat Week

PHFaust: Best known from Animal Planet's Venom ER, Dr. Bush is an associate professor of emergency medicine at Loma Linda University School of Medicine, where he is also on staff in the ER as an emergency physician and envenomation (venomous animal) specialist. He has had a lifelong interest in reptiles and venomous creatures. Dr. Bush has authored over 50 publications on the treatment of bites and stings and has lectured on the local, national, and international level. He has been featured in dozens of television documentary productions on several cable networks in addition to Animal Planet.

PHFaust: Ready to go?

Dr_Sean_Bush: Thank you for inviting me. I'm ready to go.

AggieMan: i was thinkin whats the worst snake bite you've ever seen, what was the damage done, did the person survive?

Dr_Sean_Bush: You haven't been watching Animal Planet. The worst case I've seen was the patient who died. 2nd worst: Ralph

AggieMan: From what snake?

Dr_Sean_Bush: Southern Pacific rattlesnake

AggieMan: How long was it until the person received medical attention?

AggieMan: (yes and sorry I haven't seen your show in a long time...but when i did watch, it was VERY interesting) Dr_Sean_Bush: He sought medical care relatively promptly (i.e., within a few hours). See episode 2 of Venom ER for more on this fatal snakebite. See all 11 episodes - check Animal Planet for show times.

Wolfy-hound:Thank you for coming to answer questions. For someone that is interested in keeping venomous reptiles, what NON-venomous snake would you reccomend to get used to the idea of handling the potentially dangerous venomous species?

Dr_Sean_Bush: I wouldn't recommend handling venomous snakes at all unless you are prepared to be bitten. My favorite nonvenomous snake is the cornsnake.

Dr_Sean_Bush: By the way, you can get a venomous snake that is not venomous dangerous (such as a hognose snake). Actually, Bryan Fry says they're all venomous. GA

Wolfy-hound:Thank you

Adam105_nr: First of all, thank you for coming tonight! I am honored to be able to speak to you. Ok, so what got you interested in venomous snakes originally and what sparked you to take that to this extent? Also, do you keep any non-venomous snakes in your personal collection? If so, what species? Pertaining to your show though, is it frustrating with some people? For example when I saw the lady that was convinced she had been bit but really wasnt.

Dr_Sean_Bush: It all started when I was about 5 years old and my grandfather gave me a venomous snake for a pet. (Actually, it wasn't dangerously venomous, it was a rear-fanged hognose snake.) Nonetheless, it sparked an interest that has persisted my whole life. As an intern on pediatric ICU rotation, I followed a patient with a really severe rattlesnake envenomation. He was on a ventilator for three weeks and had almost every complication of snakebite possible and then some. He was one of the sickest patients that I had ever seen at the time. I was amazed that snakebite could affect so many organ systems and wreak so much havoc on the human body.

feline89_nr: thanks for coming,it is an honor for me as well,is it true that venom actually spreads quicker if person moves around too much after being bitten,or panics?im not sure if i heard that on you're show or another one

Dr_Sean_Bush: It is true that mobilization enhances systemic spread of venom. There are pros and cons to this...GA

Reptilefreak16: Hello Dr.Sean Bush, i seen on one of your episodes, there was a boy that was bitten by a black widow, and was in alot of pain for obvious reason, and even tho being bit on the foot(i believe) he swelled up in the face and all over his body. the parents had to decide weather or not to use the antivenom, cause it was a major risk. What causes the black widow anti venom, to seem to have a seemingly higher risk then other antivenoms when giving to a patient.?

Dr_Sean_Bush: Impurities in the antivenom can lead to life-threatening side effects, such as anaphylaxis. Many antivenoms have similar risk--some more, some less. GA

Lakers08_nr: are corn snakes poisionous

Dr_Sean_Bush: Corn snakes aren't considered to be dangerously venomous; but Bryan Fry has found venom in lots of reptiles where we previously didn't know it existed. Suggest talk more to BGF about that. GA

goini04: Dr. Bush, some sources claim that the usage of a device such as the Sawyer Extractor can cause more harm than good after a venomous snakebite. I have found snakebite protocols on this site: http://www-surgery.ucsd.edu/ent/DAVIDSON/Snake/proinde.htm which recommends the usage of the sawyer extractor. What are your thoughts on their usage and if you do not recommend their usage, can you point me to snakebite protocol listings in which provide alternate methods? Thank you.

Dr_Sean_Bush: I have studied the Sawyer Extractor Pump extensively and found that it does not remove enough venom to make a clinical difference. In fact, I wrote an editorial about it: "Snakebite venom suction devices don't remove venom--they just suck." You can access this editorial via PubMed or through the Venom ER web site. GA

bthacker: .....What percentage of patients do you see annually that the bites are from irresponsible keepers own handling mistakes? What kind of hots do you personally keep if any? Thank you for being here....and keep up the good work!

Dr_Sean_Bush: It's hard to answer that question exactly because it requires so much judgement. I can say that over half of the bites I see are intentionally interactive. I keep rattlesnakes and a Gila Monster.

Dr_Sean_Bush: I like Mexican milksnakes, too. GA

Chance: What are your thoughts on the private keeping of venomous reptiles?

Dr_Sean_Bush: It can be a good thing if done responsibly. GA

geofri: dr bush, what can you telll me about the venom of the false water cobra?

Dr_Sean_Bush: It can cause some swelling, possibly more if a bite is prolonged. GA

coastalherper: Dr. Bush thanks for coming! Have you ever been bit by any poisonous snake(s)? If so what type(s)?

Dr_Sean_Bush: I've never been bitten by anything dangerously venomous. However, I was almost bitten by a sea snake once. And I was stung by a bark scorpion...that's probably the most dangerous envenomation I've ever had.

eunectes4: Hi Dr. Bush. I had heard before C. molossus was looked at as not being effectively treated with CroFab a while back and recently C. helleri was shown to have less effective treatment on rodents when CroFab was used. When human bites were examined it seemed to be effective.? Are there currently Crotalus species which CroFab is not proving as the best effective treatment? Also, has Echis AV been proven as effective on Atheris. I heard this but have not seen any scientific studies. Sorry for the long question.

Dr_Sean_Bush: Good question! Actually, I studied this and found that CroFab is effective for C. helleri envenomation (but not all of them I later found) and not as effective as for Mojave toxin.

Dr_Sean_Bush: Some antivenoms have cross-protection but we have lots to learn about it. GA

PHAlex: Hi Dr. Bush, do you think crofab production will increase to the point that there is enough for all major hospitals to have access to it? Thanks

Dr_Sean_Bush: It already has. GA

jeffb: I was recently zapped by a little mexican jumping spider and it felt like I had been hit by a stun gun. An almost electric shock. I have heard most snake venom reacts the same. Do your patientes report this?

Dr_Sean_Bush: Envenomation is an extremely variable experience. Some patients report a lot of pain and some report little or none. GA

PHFaust: Sean, I know you are really pressed for time... We have MANY Questions in the queue. Can I get the members to email them to me and we can do it as an attachment to the log?

jeffb: Thank you very much

PHFaust: We are at the hour and I know Dr. Bush really readjusted his schedule to be here...

jeffb: He has patients to see

Dr_Sean_Bush: Yes, please email the questions in the queue...but for now I've got to go. I enjoyed the chat and wish I could stay longer! Thank you for the invitation. Hope to do it again someday. If there is a transcript of the session, I would like one...if so, please email me privately. Dr. Sean P. Bush, MD, FACEP, Professor of Emergency Medicine, Staff Emergency Physician & Envenomation Specialist, Department of Emergency Medicine, Room A108, Loma Linda University School of Medicine, Medical Center & Children's Hospital

PHFaust: On Behalf of Jeff B and all of us here at Kingsnake THANK YOU! We will have you back again soon
-----
Cindy
PHFaust

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