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Resource Utilization After Snakebite Severity Score Implementation into Treatment Algorithm of Crotaline Bite
Amanda L Fowler1, Darrel W Hughes2, Mark T Muir3
1Department of Pharmacy, University Health System, San Antonio, Texas; Pharmacotherapy Division, the University of Texas at Austin College of Pharmacy, Austin, Texas; Pharmacotherapy Education and Research Center, the University of Texas Health Science Center at San Antonio, San Antonio, Texas.
Implementing a Snakebite Severity Score (SSS) protocol significantly reduced Crotalidae antivenin use in snakebite patients. This approach decreased treatment costs without impacting other healthcare outcomes.
Area of Science:
- Toxicology
- Emergency Medicine
- Clinical Practice Guidelines
Background:
- Crotaline envenomation presents with variable clinical signs, complicating treatment decisions.
- Assessing envenomation control is crucial for guiding Crotalidae polyvalent immune Fab therapy.
- Standardized assessment is challenging across different clinical settings and providers.
Purpose of the Study:
- To evaluate the impact of a Snakebite Severity Score (SSS) protocol on Crotalidae antivenin utilization.
- To compare the total number of antivenin vials administered before and after SSS protocol implementation.
Main Methods:
- Retrospective review of medical records for patients diagnosed with snakebite.
- Comparison of resource utilization between pre-protocol and post-SSS protocol treatment groups.
- Analysis conducted at an academic medical and regional Level I trauma center.
Main Results:
- 146 patients were analyzed; 127 received antivenin.
- The post-SSS protocol group used fewer antivenin vials (median 12) compared to the pre-protocol group (median 16).
- This reduction in antivenin use resulted in an estimated cost saving of $13,200 per patient, with no significant difference in hospital stay, ICU admission, opioid use, transfusions, or need for surgery/intubation.
Conclusions:
- A protocol utilizing the Snakebite Severity Score (SSS) effectively guides antivenin administration.
- SSS protocol implementation leads to significantly reduced antivenin therapy for snakebite patients.
- The protocol achieved cost savings without increasing other healthcare resource utilization.
