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Important Snakebite Information

phobos Sep 29, 2006 07:34 AM

Chuck Seifert covers importantant do's and don'ts when bitten.

Cudo's Chuck!

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Sound familiar?

Our office receives way too many calls from patients inquiring about their recent snakebite and the hospitals treatment (before, during and after). Too many times I have heard about a patient being sent to another hospital due to the fact that the 1st hospital wasn’t “equipped to handle a snakebite” (in other words they don’t have anti-venom). As well as, “well the bite doesn’t seem life threatening, we will just monitor the patient” (while the finger/foot/hand is being destroyed by the venom) most native bites aren’t life threatening, you give anti-venom to save the effected limb. I have also, been called by more than a few hospitals requesting North American anti-venom be cause they only have “a few vials” (minimum amount of anti-venom for North American Pit Vipers is 10 vials per the manufacture) or none at all (there is no excuse for any hospital in North America near areas that have known populations of venomous snakes not stock it). People would never allow hospitals to get away with not having the proper medicines or equipment or treatment to save your life or limb! Why do people think it’s any different with a snakebite? I often hear “it was the doctor’s first bite” do think that would work in a court of law if it was his first surgery? So let’s say it is his first bite and he’s not sure what to do, that is why we have Poison Control Centers with one universal number through out the USA (1800-222-1222). I do understand some of the stories I hear from patients with exotic bites but not natives!

Well I have vented and I don’t feel better but please remember this… If you have a known envenomation form a North American Pit Viper

• “Time is tissue” don’t wait to see if it gets worse, make them start mixing anti-venom this can take up to 30 minutes vial (starting dose is 4-6 vials repeat this dose until signs are “under control” then follow with 2 vials every 6hrs over the next 18 hours)

• “Swirled not shaken” anti-venom is a protein shaking it can make it less effective ( U.S. pit viper anti-venom is freeze dried they have to add water in the vial and place vial between hands and rub causing it to swirl)

• If you have a snakebite, which left a break in the skin, pain and swelling it’s not a Dry Bite! I would recommend anti-venom (so some may say “I did get any, and I had that, but my finger is fine” well count your blessings because there are some that can’t say that.

• “Anaphylaxis” thousands of deaths have been documented from this after people have taken aspirin at home. Yet it’s the first thing they give you in an ER when you walk in complaining of chest pain is aspirin. Even before a doctor see you. And not even one death from anti-venom has been attributed to anaphylaxis in the US in over 40 years.

• If they don’t seem to know what there doing have them call Poison Control (1800-222-1222) or due it yourself.

• Don’t blame yourself! I have spent 17 years in emergency medicine I have never once told a person, who was in a car accident, that was in need of care that they shouldn’t be driving a car because cars are dangerous. 40,000 people are killed in result of car accidents a year in the US that’s an average of a 109 people a day!

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Lieutenant Charles R. Seifert
Miami-Dade Fire Rescue
Venom Response Team
9300 NW 41st Street
Miami, FL. 33178
(786) 331-4444 Office
(786) 229-0430 Cell
(305) 222-2125 Fax
(305) 366-3087 Pager
Unit E-mail: mdfrantivenom@miamidade.gov
My E-mail: seifert@miamidade.gov
Web site: www.venomone.com

“No Animal has been more worshipped yet more cast out, more loved yet more despised, more envied yet more caged, and more collected yet more trampled upon than the snake.” Findlay E Russel MD.
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Light travels faster than sound. This is why some people appear bright until you hear them speak.

Replies (2)

Greg Longhurst Sep 29, 2006 06:39 PM

To the best of my knowledge, anaphylaxis is possible from antivenin. A friend of mine was treated quite a few years ago for the bite of a large Sistrurus. Within seconds of the first of the Wyeth being administered, my friend blacked out & awoke a bit later with half the staff of the emergency room on his chest.

Now this does not mean that death from antivenin has occurred, but I can see the possibility that it could happen.

~~Greg~~

flherp Sep 29, 2006 10:32 PM

Anaphylaxis is treated can be treated in a hospital setting with numerous measures. I am sure this post did not intend to dismiss the potential for anaphylaxis, but if there is a definite envenomation problem, is the concern over a potential problem of equal or greater significance? A patient who may be suspected of having allergies to ovine (sheep) derived antivenoms or equine (horse) derived antivenoms can be premedicated to reduce the incidence of anaphylaxis. They should also be monitored for rebound. It is not an unmanageable problem in a hospital, where these events are dealt with on a daily basis. Many hospitals may be at a loss concerning management of an envenomation, none should have any problem whatsoever with treating an anaphylactic patient.

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