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Resident: A Case of Snake Bite
EP30851
Poster Title: Resident: A Case of Snake Bite
Submitted on 17 Oct 2019
Author(s): Sandeep Dhaliwal, MD; G. E. Alan Dever, MD, PhD; Viktoria Nurpeisov, MD, FAAFP, Omari Hodge MD
Affiliations: Wellstar Kennestone Hospital Family Medicine Residency Program
Poster Views: 327
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Poster Information
Abstract: Snakebites, although uncommon, are a potentially deadly emergency in the United States. In general, 7/10 snakebites are from non-poisonous snakes and rest are caused by poisonous snakes. Unavailability of credible information from the site or witness to differentiate poisonous snakebites from non-poisonous snakebites, in most cases require each case to be taken seriously and treated emergently. Venomous snakes in the United States can be classified as having hemotoxic or neurotoxic venom. Equine-derived anti-venin is considered the standard of care; however, less allergenic sheep-derived antigen binding fragment bovine (CroFab) anti- venin is also available and is tolerated better than the later. Therefore, a prompt diagnosis and timely administration of anti-venin, in a case of snakebite can not only be life saving, but also prevent morbidity to a great extent. Patients with snakebites should undergo a comprehensive work-up to look for possible hematologic, neurologic, renal, and cardiovascular abnormalities and prevent complications. This is a case about 10 year-old boy who experienced a snakebite that resulted from removing a mulch from a bag of mulch purchased at a lowes home store. Treatment was needed immediately and extensive. Summary: Each year, approximately 8,000 venomous snakebites occur in the United States. Most snakebites occur between April and October, when outdoor activities are popular. The major types of poisonous snakebites in the USA includes Crotalinae which include pit vipers (rattlesnakes, copperhead, water moccasins) and Elapidae (coral snakes). Venom is cytotoxic and hematotoxic. The Crotalinae bite are by far the most common accounting for around 95% of bites. References: References:
1. Snyder CC, Knowles RP. Snakebites. Guidelines for practical management. Postgrad Med. 1988;83:52–60,65–8,71–5.
2. Parrish HM. Incidence of treated snakebites in the United States. Public Health Rep. 1966;81:269–76.
3. Juckett G. Snakebite. In: Rakel RE, ed. Saunders Manual of medical practice. 2d ed. New York: Saunders, 2000:1525–8.
4. Wingert WA, Chan L. Rattlesnake bites in southern California and rationale for recommended treatment. West J
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