Snakebite Survivors Club: Retrospective review of rattlesnake bites in Central California

Spano, Susanne; Macias, Fernando; Snowden, Brandy; Vohra, Rais

doi:10.1016/j.toxicon.2012.11.015

Cited by 14 publications

(6 citation statements)

References 15 publications

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“…The concept has been described as bite Blegitimacy^ [16]. The predominance of upper extremity bites reported in numerous studies is consistent with intentional interactions with the snake [16][17][18][19]. Contrary to these historical reports, our results reflect a change in this pattern, and are more consistent with a recent study of snakebite reports in the media, which found 68% of bites to be legitimate encounters [20].…”

Section: Discussionsupporting

confidence: 89%

The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry

et al. 2017

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The American College of Medical Toxicology established the North American Snakebite Registry (NASBR), a national database of detailed, prospectively collected information regarding snake envenomation in the United States, in 2013. This report describes the epidemiology, clinical course, and management of snakebites in the NASBR. All cases entered into the NASBR between January 1, 2013 and December 31, 2015 were identified. Descriptive statistics are used to report results. Fourteen sites in 10 states entered 450 snakebites. Native species comprised 99% of cases, almost all of which were pit viper bites. 56.3% were identified as rattlesnakes and 29.4% as copperheads. 69.3% were male and 28.2% were children age 12 and under. Fifty-four percent of bites were on the lower extremity. Twenty-seven percent of patients with lower extremity bites were not wearing shoes. Common tissue findings associated with envenomation were swelling, ecchymosis, and erythema. Systemic effects and hematologic toxicity were more common in rattlesnake than copperhead or cottonmouth envenomations. Crotalidae Polyvalent Immune Fab antivenom was given to 84% of patients. Twelve patients (4.3%) were re-admitted to the hospital after completion of treatment. Eight were re-treated with antivenom. The NASBR gathers detailed data on venomous snakebites across the US. In its initial years, useful information has already been gained. Data regarding footwear will inform public health interventions and education, and information regarding the clinical presentation may help physicians better anticipate effects and manage snakebite. As the number of cases in the NASBR grows, associations between patient-related factors and outcomes may be studied.

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Section: Discussionsupporting

confidence: 89%

The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry

et al. 2017

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“…Male sex has been described as a risk factor for venomous snakebites among regional and national reports, with 69% to 80% of snakebite victims having been reported as male 2–4 13 20–23. Our study found that 65% of snakebite victims were male.…”

Section: Discussionsupporting

confidence: 47%

“…Alcohol consumption may be a risk factor for snake envenomations 14. Existing literature has reported variable proportions of snakebites related to alcohol consumption, with findings ranging from 1% to 64% 13 14 21 42–44. A recent report of US poison control data reported that only 1% of snakebites were associated with alcohol or drug use 31.…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for venomous snakebites are attributed to colloquial nouns, verbs, and adjectives that start with the letter T: the so-called “T’s of snakebites.” The risk factors include testosterone, teasing, touching, trucks, tattoos & toothless (poverTy), Texas, tequila, teenagers, and tanks (vivarium) (online supplementary file). 9–11 Yet there is limited research describing risk factors for venomous snakebites among a nationwide cohort 12–16. We performed an epidemiologic assessment of venomous snakebites in the USA with the objective of evaluating the validity of the “T’s of snakebites” at a national level.…”

Section: Introductionmentioning

confidence: 99%

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The “T’s” of snakebite injury in the USA: fact or fiction?

Jaramillo

Hakes

Tennakoon

et al. 2019

Trauma Surg Acute Care Open

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BackgroundVenomous snakebites can result in serious morbidity and mortality. In the USA, the “T’s of snakebites” (testosterone, teasing, touching, trucks, tattoos & toothless (poverTy), Texas, tequila, teenagers, and tanks) originate from anecdotes used to colloquially highlight venomous snakebite risk factors. We performed an epidemiologic assessment of venomous snakebites in the USA with the objective of evaluating the validity of the “T’s of snakebites” at a national level.MethodsWe performed a retrospective analysis of the National Emergency Department Sample. Data from January 1, 2016 to December 31, 2016 were obtained. All emergency department (ED) encounters corresponding to a venomous snakebite injury were identified using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes. Primary outcomes were mortality and inpatient admission. Demographic, injury, and hospital characteristics were assessed. Data were analyzed according to survey methodology. Weighted values are reported.ResultsIn 2016, 11 138 patients presented to an ED with a venomous snakebite. There were 4173 (37%) persons aged 18 to 44, and 7213 (65%) were male. Most snakebites were reported from the South (n=9079; 82%), although snakebites were reported from every region in the USA. Only 3792 (34%) snakebites occurred in rural counties. Persons in the lowest income quartile by zip code were the most heavily represented (n=4337; 39%). The most common site of injury was the distal upper extremity (n=4884; 44%). Multivariate analysis revealed that species of snake (OR=0.81; 95% CI 0.73 to 0.88) and older age (OR=1.42; 95% CI 1.08 to 1.87) were associated with hospital admission. There were <10 inpatient deaths identified, and no variables were predictive of death.DiscussionSome of the “T’s of snakebites” may be valid colloquial predictors of the risk for venomous snakebites. Based on national data, common demographics of venomous snakebite victims include lower income, Caucasian, and adult men in the South who are bit on the upper extremity. Understanding common demographics of venomous snakebite victims can effectuate targeted public health prevention messaging.Level of evidenceIV.

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“…Not all bites, however, develop into envenoming. In approximately 10-30% of bites the snake does not inject venom (a "dry bite") (Spano et al, 2013;Valenta et al, 2014).…”

Section: Signs Of Snakebite and Envenomingmentioning

confidence: 99%

Severe Snakebite Envenoming in Intensive Care

2016

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Snakebites by exotic venomous snakes can cause serious or even life-threatening envenoming. In Europe and North America most victims are breeders, with a few snakebites from wild native American rattlesnakes. The envenomed victims may present in organ and/or system failure with muscle paralysis, respiratory failure, circulatory instability, acute kidney injury, severe coagulation disorder, and local disability - compartment syndrome and necrosis. Best managed by close collaboration between clinical toxicology and intensive care, most severe envenomings are managed primarily by intensive care physicians. Due to the low incidence of severe envenoming, the clinical course and correct management of these cases are not intrinsically familiar to most physicians. This review article summarizes the clinical syndromes caused by severe envenoming and the therapeutic options available in the intensive care setting.

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Snakebite Survivors Club: Retrospective review of rattlesnake bites in Central California

Cited by 14 publications

References 15 publications

The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry

The Epidemiology, Clinical Course, and Management of Snakebites in the North American Snakebite Registry

The “T’s” of snakebite injury in the USA: fact or fiction?

Severe Snakebite Envenoming in Intensive Care

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