Medical Toxicologists Provide Expertise for the Management of Snakebites

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The American College of Medical Toxicology announces the beginning of so-called snakebite season, having noted a recent rise in the number of patients treated for snake envenomation. Thousands of people are bitten by venomous snakes in the US annually. Medical toxicologists have specialized training in managing these envenomed patients.

American College of Medical Toxicology

If bitten by a snake, victims should focus on getting medical attention as quickly as possible.

The American College of Medical Toxicology reports a recent seasonal increase in the number of patients cared for by medical toxicologists as a result of a snakebite. According to data from the ToxIC registry, a national database of patients treated by medical toxicologists for poisonings and envenomations, snakebites resulting in hospitalization tripled in early April compared to the entire previous month. These numbers are expected to continue to rise as the weather warms and the snakes emerge from their winter dormancy.

Thousands of people are bitten by venomous snakes in the United States each year, resulting in hundreds of hospitalizations and nearly a dozen fatalities. Medical toxicologists are specially trained in management of snakebite, which can be complex due to effects of snake venom on various organ systems. Treatment often involves careful monitoring of blood tests and tissue effects, as well as use of antivenom, an expensive drug that acts by binding to snake venom proteins and facilitating their elimination from the body. Even after treatment with antivenom and release from the hospital, many patients require close follow up with a physician for weeks after the bite.

Research by internationally recognized experts in medical toxicology has lead to advances in the treatment of snake envenomation. Fasciotomy, a procedure where the affected limb is cut open, is now recognized as unnecessary following nearly all snakebites. Refinement in North American rattlesnake antivenom has also resulted in far fewer adverse reactions than once occurred.

The ACMT advises the public to use extra caution in the coming months in outdoor areas where snakes may be present. Awareness of one’s surroundings and protective footwear can help avoid dangerous bites. If bitten by a snake, victims should focus on getting medical attention as quickly as possible. Many first aid treatments such as cutting the wound, attempts to suction out the venom, tourniquets, or compression bandages may delay time to definitive care and in some cases produce harm. A position paper recommending against use of pressure immobilization bandages for treatment of North American snakebite, endorsed by the ACMT with five other national and international organizations, has been published in the Journal of Medical Toxicology.

Medical toxicologists also warn against handling dead or decapitated rattlesnakes, since these may still produce a serious envenomation. Identification of a specific native rattlesnake species is not necessary for physicians to determine treatment, so victims and bystanders should never put themselves or others at risk in an attempt to identify the snake.

Medical toxicologists may be consulted directly or through regional poison centers.

The American College of Medical Toxicology (ACMT) is a professional, nonprofit association of physicians with recognized expertise in medical toxicology. The College is dedicated to advancing the science and practice of medical toxicology.

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