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Comparative Study
. 2001 Feb;8(2):177-82.
doi: 10.1111/j.1553-2712.2001.tb01284.x.

Epidemiology and hospital course of rattlesnake envenomations cared for at a tertiary referral center in Central Arizona

D Tanen  1 , A Ruha, K Graeme, S Curry
Affiliations
Comparative Study

Epidemiology and hospital course of rattlesnake envenomations cared for at a tertiary referral center in Central Arizona

D Tanen et al. Acad Emerg Med. 2001 Feb.

Abstract

Objective: To describe the demographics and primary inpatient treatment of victims of rattle-snake bites (RSBs) referred to a teritiary referral poison treatment center in central Arizona, and to compare the frequency of local tissue complications and hematologic toxicity during hospitalization in children with those for adults.

Methods: This was a chart review of patients diagnosed as having RSB by a toxicology service between July 1994 and April 2000. Data collected included: age, sex, date, bite location, time to and length of hospitalization, time to and amount of antivenin, serial hematologic studies, and inpatient complications.

Results: Of 241 patients admitted, 236 charts met inclusion criteria. The majority of RSB victims were male (81%). Children (< or =13 years) represented 22%. Most RSBs (78%) occurred between April and September. Mean time (+/-SEM) to presentation was 1.7 +/- 0.2 hours. Antivenin was administered to 77% of patients, with an average (+/-SEM) of 28.5 +/- 0.9 vials administered. Hematologic abnormalities included: coagulopathy (60%), hypofibrinogenemia (49%), and thrombocytopenia (33%). No statistically significant difference in the above parameters was detected between upper- and lower-extremity envenomations, or between children and adults. Immediate antivenin reactions occurred in 36% of patients. Hemorrhagic bullae formation occurred in 22%, occurring most frequently in upper extremities. Operative procedures were required in 3.4% of patients. Hospitalization averaged 2.5 +/- 0.1 days. There was no fatality.

Conclusions: In Arizona, RSB victims were typically adult males with upper-extremity bites. Hematologic abnormalities were common. Local tissue complications were more common with upper-extremity envenomations. No statistically significant difference was detected in frequency of hematologic disorders or local tissue complications when children were compared with adults.

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Comment in

  • Rattlesnake bites.
    Tanen DA. Tanen DA. Acad Emerg Med. 2001 Jun;8(6):688. doi: 10.1111/j.1553-2712.2001.tb00185.x. Acad Emerg Med. 2001. PMID: 11388947 No abstract available.

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