Unified treatment algorithm for the management of crotaline snakebite in the United States: results of an evidence-informed consensus workshop.

Background: Envenomation by crotaline snakes (rattlesnake, cottonmouth, copperhead) is a complex, potentially lethal condition affecting thousands of people in the United States each year. Treatment of crotaline envenomation is not standardized, and significant variation in practice exists.Methods:...

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Publicado en:BMC Emergency Medicine Vol. 11; no. 1; pp. 2 - 3
Autores principales: Lavonas, Eric J, Ruha, Anne-Michelle, Banner, William, Bebarta, Vikhyat, Bernstein, Jeffrey N, Bush, Sean P, Kerns 2nd, William P, Richardson, William H, Seifert, Steven A, Tanen, David A, Curry, Steve C, Dart, Richard C, Kerns, William P 2nd
Formato: practice guidelines research Journal Article
Publicado: BioMed Central 2011
Acceso en línea:Ver este registro en EBSCOhost
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        10.1186/1471-227X-11-2
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        atl: Unified treatment algorithm for the management of crotaline snakebite in the United States: results of an evidence-informed consensus workshop.
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        au:
          Lavonas, Eric J
          Ruha, Anne-Michelle
          Banner, William
          Bebarta, Vikhyat
          Bernstein, Jeffrey N
          Bush, Sean P
          Kerns 2nd, William P
          Richardson, William H
          Seifert, Steven A
          Tanen, David A
          Curry, Steve C
          Dart, Richard C
          Kerns, William P 2nd
        affil: Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver, Colorado, USA. eric.lavonas@rmpdc.org.
      sug:
        subj:
          Algorithms
          Decision Support Techniques
          Snake Bites Therapy
          Reptiles
          Animals
          Antivenins Administration and Dosage
          Antivenins Adverse Effects
          Venoms
          Delphi Technique
          Human
          Snake Bites Diagnosis
          Snake Bites Physiopathology
          United States
      ab: Background: Envenomation by crotaline snakes (rattlesnake, cottonmouth, copperhead) is a complex, potentially lethal condition affecting thousands of people in the United States each year. Treatment of crotaline envenomation is not standardized, and significant variation in practice exists.Methods: A geographically diverse panel of experts was convened for the purpose of deriving an evidence-informed unified treatment algorithm. Research staff analyzed the extant medical literature and performed targeted analyses of existing databases to inform specific clinical decisions. A trained external facilitator used modified Delphi and structured consensus methodology to achieve consensus on the final treatment algorithm.Results: A unified treatment algorithm was produced and endorsed by all nine expert panel members. This algorithm provides guidance about clinical and laboratory observations, indications for and dosing of antivenom, adjunctive therapies, post-stabilization care, and management of complications from envenomation and therapy.Conclusions: Clinical manifestations and ideal treatment of crotaline snakebite differ greatly, and can result in severe complications. Using a modified Delphi method, we provide evidence-informed treatment guidelines in an attempt to reduce variation in care and possibly improve clinical outcomes.
      pubtype: Academic Journal
      doctype:
        practice guidelines
        research
        Journal Article
      ougenre: Article
    language: English
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