POISONOUS SNAKEBITE IN UTAH

A retrospective study was done of poisonous snakebite in Utah to deter mine the current epidemiology and scope of treatment, reviewing emerge ncy department logs and other sources statewide for a 69-month period. Of 61 cases of poisonous snakebite identified, 13 occurred in snake h obbyists or venom laboratory personnel and were considered nonaccident al, and 48 were inflicted by native non-captive snakes. These bites we re considered accidental, and all were presumed to be from rattlesnake s. Nearly three fourths of the victims were male, ranging in age from 2 to 56 years (mean, 22 years). Most accidental bites occurred in area s of high human populations, during the summer months, in the afternoo n or evening hours, and during recreational activities. Of the 48 bite s, 11 (23%) were provoked. Two thirds of bites were on the upper extre mities, and a third were on the lower extremities. More than half of t he victims had no first-aid treatment recorded. Of those who did recei ve first aid, many were subjected to possibly harmful treatments, incl uding tourniquets and ice application. The median time to a hospital w as 68 minutes, with a range of 15 to 440 minutes. Swelling and discolo ration were the most common signs and pain and paresthesia the most co mmon symptoms. Half the bites resulted in minimal or no envenomation, 17 (35%) produced moderate envenomation, and 6 (12%) severe envenomati on. Most patients with moderate or severe envenomation received antive nin, but the dosages given were usually less than recommended dosages. Five patients received surgical treatment based on clinical findings, One child died in a snake-handling incident. Long-term morbidity was unknown due to lack of follow-up. The Utah Poison Control Center was p oorly utilized as a reporting and informational resource.