Reptile & Amphibian Forums

Hi Everyone:

I CANNOT stress the need to have proper bite protocols and Expert contact phone #'s to take with you to the hospital if bitten.

A friend was bitten last evening by his 4ft EDB. When to hospital "A" where he was given 5 vials of Crofab but no more because of the "Liability issues" the hospital/physicians had with the drug. Those Stupid idiots!! If they read the perscribing information they would have known " up to 18 vials have been given with no ill effects. Dr. Sean Bush has given 58 vials to a patient without any problems.

He was transfered to Hospital "B" when they gave an additonal 10 vials but wanted to do a Faciotomy. The patient declined and the physician was told that was not a "good idea:" and was not thought to be a clinially required proceedure. Get this: They are worried about swelling,so what do they do? They wrap the arm tightly with a bandage to keep the pressure high and keep all the venom in the patients arm. They don't even make the swelling progression on the arm to see if the A/V is being effective.

Again we were able to inform the doctors and get them intouch with a local doctor who is experienced with snakebite and he seem to be doing well at the moment.

IF you only do one thing, take the names & phone numbers of snakebite experts with you to the hospital, this could be the single most important tool besides Antivenom to save your life.

Some People I would want on the phone to direct the physicians who to treat a snakebite, not in any particular order:

The nice people at Miami Dade Venom 1
Chris Harper
Arizona Poison Control

These people treat many bites per year and will help you, that's their job and we thank them for the great job they do! If you need them put them to work!

If all else fails you can contact me, If I don't know, I know who to ask.

Al Coritz
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Save a Rattlesnake...Skin a Sweetwater Resident!

wow...that would suck...have a doc with medicine to save your life and they dont know how to use it.
Hope your friend recovers fully

Update:

I talked to the patient about an our ago (~5:00 est)and was doing okay. I am leaving for Israel tonight otherwise I would have gone to the Medical Center where he is now. His clotting factors were within the normal range and just finished 2 more vials of Cro-fab. They got hold of the Physician who Matt Harris and I recomended, who is the NEAVB's Medical Director. He is experienced in Snakebites and is talking to the Attending where the patient is being treated. He directed the local physician what he has to do and seems to be following protocol now, I am relieved that he is getting the proper treatment.

He has vessicals of various size on his index finger and the color is getting darker, not surprising. He was hit with one fang near the first knuckle. No, I did not ask how it happened, maybe after he is well. I'm expecting he will have some deficit on that digit and hoping that will be all. The swelling is up to his shoulder. This will all take time to subside, a few months at least.

The nurses told me that there were also talking to Jim Harrison, at KRZ for support. Thanks Jim! This was the only smart things they seemed to do!

Best,

Al
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Save a Rattlesnake...Skin a Sweetwater Resident!

Glad your friend's doing better, Al.
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Venomous snakes---best hobby on earth!
Bill Huseth

I couldn't agree with you more Al. Your points should be heeded by every hot herp keeper. Unfortunately, the younger generation feel that they are invincible and as such, tend to fail to forget important information like this. Our own facility is in the process of revamping our policies and we have now listed the names/numbers of experts in the field (like those that you mentioned). Thanks for this post.

Rob Carmichael, Curator
The Wildlife Discovery Center
Lake Forest, IL

>>Hi Everyone:
>>
>>I CANNOT stress the need to have proper bite protocols and Expert contact phone #'s to take with you to the hospital if bitten.
>>
>>A friend was bitten last evening by his 4ft EDB. When to hospital "A" where he was given 5 vials of Crofab but no more because of the "Liability issues" the hospital/physicians had with the drug. Those Stupid idiots!! If they read the perscribing information they would have known " up to 18 vials have been given with no ill effects. Dr. Sean Bush has given 58 vials to a patient without any problems.
>>
>>He was transfered to Hospital "B" when they gave an additonal 10 vials but wanted to do a Faciotomy. The patient declined and the physician was told that was not a "good idea:" and was not thought to be a clinially required proceedure. Get this: They are worried about swelling,so what do they do? They wrap the arm tightly with a bandage to keep the pressure high and keep all the venom in the patients arm. They don't even make the swelling progression on the arm to see if the A/V is being effective.
>>
>>Again we were able to inform the doctors and get them intouch with a local doctor who is experienced with snakebite and he seem to be doing well at the moment.
>>
>>IF you only do one thing, take the names & phone numbers of snakebite experts with you to the hospital, this could be the single most important tool besides Antivenom to save your life.
>>
>>Some People I would want on the phone to direct the physicians who to treat a snakebite, not in any particular order:
>>
>>The nice people at Miami Dade Venom 1
>>Chris Harper
>>Arizona Poison Control
>>
>>These people treat many bites per year and will help you, that's their job and we thank them for the great job they do! If you need them put them to work!
>>
>>If all else fails you can contact me, If I don't know, I know who to ask.
>>
>>Al Coritz
>>-----
>>Save a Rattlesnake...Skin a Sweetwater Resident!
-----
Rob Carmichael, Curator
The Wildlife Discovery Center at Elawa Farm
Lake Forest, IL

Rob: Your account does not surprise me. I have had two bites, one in 1971, the other in 1991. (Bitis arietans & Agkistrodon piscivorus conanti) During the first, the attending physician was smart enough to listen to me & the experienced herp who brought me to the hospital. It was a mild bite, & I was back at work the next day. For the second, the physician wanted to perform a fasciotomy on my right forearm due to the swelling. I assured him that I would leave the hospital before I allowed that procedure to take place. We came to terms, & he marked the progression of the swelling with a pen. My arm was still swollen to the point that a tee shirt sleeve made ripping noises going on the day I was released. I was fine a few days later, although I did get a mild case of serum sickness from that one. Missed a week of work.

~~Greg~~

The patient has received 21 vials of Cro-fab, so far and is doing well. Just for the record that is about $35,000 in Antiserum for a split second misjudgment. They think he will keep his finger which was in question earlier, whis is of course fantastic.

I know he's feeling better since he asked me to take pictures of "Hot" Israeli Chicks and any ECHIS is find.

Cheers,

Al
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Save a Rattlesnake...Skin a Sweetwater Resident!

That's good to hear Al. Right now, we are trying to up our CroFab supply and it just goes to show you that you cannot overprepare when it comes to emergency procedures. Are you heading for Israel?

>>The patient has received 21 vials of Cro-fab, so far and is doing well. Just for the record that is about $35,000 in Antiserum for a split second misjudgment. They think he will keep his finger which was in question earlier, whis is of course fantastic.
>>
>>I know he's feeling better since he asked me to take pictures of "Hot" Israeli Chicks and any ECHIS is find.
>>
>>Cheers,
>>
>>Al
>>-----
>>Save a Rattlesnake...Skin a Sweetwater Resident!
-----
Rob Carmichael, Curator
The Wildlife Discovery Center at Elawa Farm
Lake Forest, IL

Hi Rob:

I am in Israel I hope to be herping later this week with some photos to share by weekend.

Major congrats on your nice write up in the June issue of "Reptiles" "Rattlesnake exhibit opens in Illinois" I wish you great success with this effort.

As far as your A/V stocks for "domestic snakebite" you may want to consider stocking Mexican Bioclon Antivipmye Tri. It is reported to be BETTER and CHEAPER than Cro-fab. I can't say why I know this on the open forum but I have reasons, email me directly if you're interested. See link for A/V.

Cheers!

Al
Antivipmye Tri (Trivalent)

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Save a Rattlesnake...Skin a Sweetwater Resident!

Let us know how herping in Israel goes; hopefully, the locals will stear you into the right direction. We seriously considered Bioclon but our insurance carrier preferred (strongly recommended....as in, "you will" that we purchase the CroFab because it is FDA approved in the U.S. I didn't want to burn any bridges with the folks who allow me to do what I do. For our foreign A/V's (SAIMR, etc.) that may not be FDA approved are still okay because there are no U.S. commercially available alternatives. Anyway, things get sticky when you are indirectly involved in the government.

The write up in Reptiles was nice and we are getting a lot of exposure in other reptile related magz/etc. If you are ever in the Chicago area let me know and I will give you the grand tour. Rob

>>Hi Rob:
>>
>>I am in Israel I hope to be herping later this week with some photos to share by weekend.
>>
>>Major congrats on your nice write up in the June issue of "Reptiles" "Rattlesnake exhibit opens in Illinois" I wish you great success with this effort.
>>
>>As far as your A/V stocks for "domestic snakebite" you may want to consider stocking Mexican Bioclon Antivipmye Tri. It is reported to be BETTER and CHEAPER than Cro-fab. I can't say why I know this on the open forum but I have reasons, email me directly if you're interested. See link for A/V.
>>
>>Cheers!
>>
>>Al
>>Antivipmye Tri (Trivalent)
>>
>>-----
>>Save a Rattlesnake...Skin a Sweetwater Resident!
-----
Rob Carmichael, Curator
The Wildlife Discovery Center at Elawa Farm
Lake Forest, IL