Associations Between Snakebite Severity Scores and Antivenin Administration

Area of Science:

• Toxicology
• Emergency Medicine
• Clinical Research

Background:

• Crotalid envenomations are common in the US, but lack standardized treatment protocols.
• Regional variations in incidence necessitate consistent management strategies.
• Snakebite Severity Scores (SSSs) are used to guide treatment decisions.

Purpose of the Study:

• To evaluate the accuracy of clinician-documented SSSs (CSSS) and retrospectively calculated SSSs (RSSS).
• To assess the association between SSSs and patient care aspects, including antivenin administration.
• To identify discrepancies in SSS calculations and their impact on treatment.

Main Methods:

• Retrospective review of 134 venomous snakebite cases at a level I trauma center (March 2017-September 2023).
• Comparison of CSSS with RSSS derived from clinical documentation.
• Analysis of discrepancies and their correlation with patient outcomes and treatment.

Main Results:

• A strong correlation was found between CSSS and RSSS (r = 0.889, P < 0.001), but discrepancies occurred in 40.5% of cases, with RSSS often higher.
• Significant variations in SSS classification and antivenin administration were noted.
• Discrepancies in SSS potentially influenced treatment decisions, including antivenin necessity and timing of care.

Conclusions:

• Inconsistent application of institutional protocols for venomous snakebites indicates a need for improved education.
• Miscalculated SSSs are linked to potential treatment delays and variability in care.
• Electronic medical record checklists may enhance SSS calculation accuracy and protocol adherence.