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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.

The Journal of Emergency Medicine
|November 6, 2017
PubMed
Summary
This summary is machine-generated.

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.

Keywords:
antiveninclinical pharmacyenvenomationoutcomespharmacoeconomicssnake bite

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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.