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Suspected snakebite: one year prospective study of emergency department presentations

Isbister, Geoffrey K. and Currie, Bart J. (2003). Suspected snakebite: one year prospective study of emergency department presentations. Emergency Medicine Australasia,15(2):160-169.

Document type: Journal Article
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Title Suspected snakebite: one year prospective study of emergency department presentations
Author Isbister, Geoffrey K.
Currie, Bart J.
Journal Name Emergency Medicine Australasia
Publication Date 2003
Volume Number 15
Issue Number 2
ISSN 1742-6723   (check CDU catalogue  open catalogue search in new window)
Start Page 160
End Page 169
Total Pages 10
Place of Publication Australia
Publisher Blackwell Publishing
Language English
Field of Research 1103 - Clinical Sciences
HERDC Category C1 - Journal Article (DEST)
Abstract AIM: Snakebite is an uncommon, but potentially life-threatening condition. The more common clinical scenario is suspected snake-bite. Our aim was to characterise the epidemiology, diagnosis and management of patients with suspected snakebites. METHODS: Prospective cohort study of patients presenting with suspected snakebites to a tertiary referral hospital serving a large rural region in tropical northern Australia where a standard admission protocol for suspected snakebites is used. RESULTS: Of 70 suspected snakebite cases, there were 45 definite bites: three severe envenomings (two western brown snakes [Pseudonaja nuchalis] and one mulga snake [Pseudechis australis]); seven mild/moderate envenomings by other snakes, two non-envenomings by identified P. nuchalis, five bites by identified non-venomous snakes and 28 definite bites without envenoming. The remaining 25 cases were either suspected bites (8), unlikely bites (15) and two people hit by snakes. Definite snake-bites occurred throughout the year, peaking in May and December. There were three severe envenomings (mainly coagulopathy), requiring antivenom treatment, but no deaths or major complications. Most patients had appropriate investigations. Of 47 venom detection kit swabs collected, 34 were not tested, venom was not detected in nine and was positive in the three envenomings with one false-positive tiger snake. Whole blood clotting time was highly sensitive for procoagulant coagulopathy and envenoming in this study. Median length of time from the bite to discharge was 20 h (interquartile range: 12-27). CONCLUSIONS: The study shows that although suspected snakebite was common, severe envenoming occurred in less than 5% of cases. The study supports the proposition that a structured approach and admission policy of suspected snakebites leads to the appropriate management of severe envenoming, with no cases discharged early and no cases of non-envenoming treated with antivenom.
Keywords emergency
snakebite
DOI http://dx.doi.org/10.1046/j.1442-2026.2003.00434.x   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes 3546 (Journal) DA - 20030404IS - 1035-6851 (Print)LA - engPT - Case ReportsPT - Journal ArticleRN - 0 (Antivenins)SB - IM
 
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Created: Mon, 17 Dec 2007, 09:02:11 CST