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Crotalidae envenomation in children

R A Weber1, R R White

  • 1Division of Plastic Surgery, Scott and White Memorial Hospital, Sherwood, Temple, TX 76508.

Annals of Plastic Surgery
|August 1, 1993
PubMed
Summary
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Pediatric poisonous snakebites can cause severe envenomation. Early surgical intervention and frequent antivenin use are recommended for children with Crotalidae envenomation, leading to good outcomes.

Area of Science:

  • Pediatric Toxicology
  • Emergency Medicine
  • Herpetology

Background:

  • Poisonous snakebites in children present a significant envenomation risk.
  • Treatment protocols for pediatric snakebites, particularly Crotalidae envenomation, remain debated.
  • This study reviews institutional experience with pediatric snakebite management.

Purpose of the Study:

  • To evaluate the clinical presentation and outcomes of pediatric patients treated for poisonous snakebites.
  • To assess the efficacy and safety of antivenin administration in children.
  • To provide recommendations for the management of Crotalidae envenomation in pediatric populations.

Main Methods:

  • Retrospective review of 67 poisonous snakebite cases from 1975-1990.
  • Analysis of 18 pediatric patients (<=12 years old) treated for rattlesnake, copperhead, or unidentified snakebites.

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  • Evaluation of initial management, antivenin use criteria, dosage, and patient outcomes.

    • Main Results:

    • Children experienced systemic involvement in 72% of cases, with 50% developing coagulopathy.
    • 61% of pediatric patients received antivenin (3.2 ml/kg), with 36% experiencing adverse reactions.
    • Despite severe envenomation, pediatric patients had good outcomes with an 8-day average hospital stay and 11% long-term morbidity.

    Conclusions:

    • Crotalidae envenomation in children is a serious condition requiring hospitalization and prompt medical attention.
    • Early surgical involvement and liberal use of antivenin are crucial for favorable outcomes in pediatric snakebite victims.
    • Aggressive management, including antivenin, leads to full recovery and minimal long-term effects in children.