TREATING THE SNAKEBITTEN CHILD IN NORTH-AMERICA - A STUDY OF PIT VIPER BITES

Background/Purpose: Snakebite envenomation is a potentially life-threa tening form of trauma, the dangers of which are amplified in children because their smaller size increases the relative dose of Venom receiv ed. The authors reviewed a large series of snakebitten children to add ress the medical and fiscal issues of treating these patients. Methods :The records of 37 snakebitten children (1987 through 1997) were analy zed for demographic data, sig ns of envenomation, use of specific ther apies (antivenin, blood products, or surgery), length of hospitalizati on, complications, and cost of care. Results: Fifty-four percent of th e children had a major envenomation demonstrated by system ic symptoma tology, laboratory analysis, or need for surgery. All children made fu ll recoveries with most receiving only supportive care (92%). The aver age time to emergency department presentation was 8 hours, where all c hildren with major envenomations and those requiring specific therapie s (surgery, clotting factors) were identified. Cost analysis showed an average of $2,450 dollars per child with the majority of expenses att ributable 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 o f major envenomation are noted within 8 hours of the bite. Copyright ( C) 1998 by W.B. Saunders Company.