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Treating the snakebitten child in North America: a study of pit viper bites
J B Lopoo1, J F Bealer, P C Mantor
1Department of Surgery, University of Oklahoma College of Medicine, Children's Hospital of Oklahoma, Oklahoma City 73126, USA.
Insights
Most children with snakebite envenomation fully recover with supportive care. Early assessment within 8 hours helps determine if outpatient management is safe and cost-effective for pediatric snakebite cases.
Area of Science:
- Pediatric Toxicology
- Herpetology
- Emergency Medicine
Background:
- Snakebite envenomation poses significant risks, especially in children due to their smaller body mass.
- Pediatric snakebites require careful medical and economic evaluation.
Purpose of the Study:
- To review medical and fiscal aspects of treating snakebitten children.
- To analyze outcomes and costs associated with pediatric snakebite cases.
Main Methods:
- Retrospective analysis of 37 pediatric snakebite cases from 1987-1997.
- Data collected included demographics, envenomation signs, therapies, hospitalization duration, complications, and costs.
Main Results:
- 54% of children experienced major envenomation, confirmed by symptoms, labs, or surgery.
- All patients recovered fully; 92% received only supportive care.
- Average emergency department presentation was 8 hours; major envenomations and specific therapy needs were identified then. Average cost was $2,450 per child, mainly due to hospitalization length.
Conclusions:
- Pediatric snakebite victims generally recover well with minimal supportive care.
- Outpatient management is safe and cost-effective for children without signs of major envenomation within 8 hours of the bite.
Background/Purpose:
Snakebite envenomation is a potentially life-threatening form of trauma, the dangers of which are amplified in children because their smaller size increases the relative dose of venom received. The authors reviewed a large series of snakebitten children to address the medical and fiscal issues of treating these patients.
Methods:
The records of 37 snakebitten children (1987 through 1997) were analyzed for demographic data, signs of envenomation, use of specific therapies (antivenin, blood products, or surgery), length of hospitalization, complications, and cost of care.
Results:
Fifty-four percent of the children had a major envenomation demonstrated by systemic symptomatology, laboratory analysis, or need for surgery. All children made full recoveries with most receiving only supportive care (92%). The average time to emergency department presentation was 8 hours, where all children with major envenomations and those requiring specific therapies (surgery, clotting factors) were identified. Cost analysis showed an average of $2,450 dollars per child with the majority of expenses attributable to length of hospitalization.
Conclusions:
Most snakebitten children completely recover with minimal supportive care, and they can be cared for safely and cost effectively as outpatients if no signs of major envenomation are noted within 8 hours of the bite.
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