BEACON STAR (Parry Sound, Ontario) 04 April 08 Parry Sound, Georgian Bay's anti-venom handler (Sarah Bissonette)
In Ontario last year, three people were bitten by an eastern massasauga rattlesnake. The anti-venom they received is managed by the provincial anti-venom depot out of the West Parry Sound Health Centre (WPSCH).
The health centre took on the job of ensuring hospitals along Georgian Bay have a supply of the refrigerated anti-venom, CroFab, in 2003, after the makers of another anti-venom stopped producing the drug. The depot allows the monitoring of the drug supply from a central location, and ensures it's where it's needed without each hospital picking up the $16,000 price tag for the minimum dose.
"We have the greatest concentration of massasaugas in Ontario, so we put a proposal in (to the province) for the anti-venom depot," said Lorraine Vankoughnett, former manager of critical care and current manager of infectious control and utilization management at the hospital.
Parry Sound has 38 vials – enough for three separate bites – of CroFab on hand and supplies hospitals taking part in the depot, including the Grey Bruce Regional Health Centre, Rouge Valley Health System, Niagara Health System, Huronia Hospital, Hotel-Dieu Grace Hospital, South Muskoka Memorial Hospital, Peterborough Civic Hospital and Sudbury Region Hospital, plus the zoos in Peterborough, Toronto and Sudbury.
The anti-venom has a shelf life of three years.
Ms Vankoughnett, nicknamed the rattlesnake nurse by her co-workers, said the health centre has received some pretty strange requests over the years, with people calling wanting to buy some of the anti-venom to take on canoe trips or for their dogs, and bringing the snake into the hospital.
"We don't want the snake, we don't want them killed," said Ms Vankoughnett.
Under provincial and federal law, the eastern massasauga rattlesnake is a threatened species with a declining habitat. According to an informational poster, the eastern massasauga rattlesnake's background colouring ranges from brownish grey to dark grey with white rimmed, dark saddle-shaped blotches on its back. It has a thick body and a diamond-shaped head and grows between 47 cm (1.5 feet) and 76 cm (2.5 feet) long.
Ms Vankoughnett said the snake is a timid amphibian by nature and only strikes if it feels threatened, after rattling its tail in warning. The most common bite locations on victims in Ontario are the foot, ankle and hand, according to statistics kept by the health centre since 2003. The highest number of snake bites in Parry Sound was 10 in 2002. Since then, the highest number in all of Ontario was seven, in 2005. The average number of bites in Ontario, since 2003, is three.
Snake bites can occur between April and October, with the more common time frame between the start of July and end of August. Ms Vankoughnett said the civic long-weekend is the most common time.
"That's their mating time," she said. "The male is on the prowl then and the female, if pregnant then, is out basking in the sun, so they're out and about more."
Once bitten, Ms Vankoughnett said people shouldn't restrict the bitten area, put ice on it or cut the area and try to suck the venom out.
"That only works in a western," she said. "The best thing is to wash it, as with any puncture wound, with soap and water and get to a the nearest hospital - you don't need to drive like a maniac," she said.
Once at the health centre, staff assess the amount of venom the snake injected, if any, and then determine if or how much of the drug to inject intravenously. Medical staff determine the amount of venom the snake injected, based on the swelling, pain level and your blood's clotting ability.
"You can actually have a bite from a rattlesnake, with no injection, and that actually occurs a quarter of the time," said Ms Vankoughnett. "We'll elect not to treat if it's mild because there are risks with the anti-venom."
A person could develop serum sickness, which Ms Vankoughnett said is similar to having the flu.
CroFab isn't approved for use in Canada because the demand is so low, said WPSHC manager of pharmacy, Heather Logan-Lane, who special orders it from the United States.
"One of the big things for me is getting it to the right people at the right time, so there are courier charges. Sometime the OPP will act as couriers," she said. "I've lent CroFab to other provinces."
The provincial government sponsors the depot. Ms Logan-Lane said, this year, it provided $32,000 in funding to buy two doses, or 24 vials, of the anti-venom.
The anti-venom depot ensures there is enough CroFab in the province at any time to cover five separate snake bikes.
"Any snake will bite you if you torment it – a chipmunk will bite you if it feels threatened," said Ms Vankoughnett. "This is neat that we have this threatened species here and they are a very timid snake. They only strike if they feel very threatened."
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