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- Title
Suspected snakebite in children: a study of 156 patients over 10 years.
- Authors
Mead, Helen J; Jelinek, George A; Mead, H J; Jelinek, G A
- Abstract
<bold>Objective: </bold>To describe the epidemiology and clinical features of children presenting to an emergency department with suspected snakebite.<bold>Design: </bold>A retrospective study of patient records.<bold>Setting: </bold>An emergency department of a children's teaching hospital (Princess Margaret Hospital) in Perth, Western Australia.<bold>Participants: </bold>All children attending the emergency department from 1984 to 1993 with suspected snakebite.<bold>Main Outcome Measure: </bold>Clinical and laboratory evidence of envenomation.<bold>Results: </bold>Over the decade studied, 156 children (mean age, six years and eight months) presented with suspected snakebite; over two-thirds (68%) were boys. In at least 31% of cases, no appropriate first aid had been applied. Only 14 children were envenomed according to clinical and laboratory criteria: 10 of these had coagulopathy; one of the 10 also had rhabdomyolysis. A Venom Detection Kit was used in 117 children. The test gave a positive result in 21 children (13%). Antivenom was given to 18 children, 14 of whom were definitely envenomed. Four of the envenomed children returned a negative result of Venom Detection Kit testing at all sites tested, and in five patients not clinically envenomed the urine specimen tested positive with the Venom Detection Kit (presumably a false positive result or subclinical envenomation). Of the 156 children, 130 were admitted to hospital, and 26 were discharged directly from the emergency department. All children recovered completely.<bold>Conclusions: </bold>(i) Many children did not receive appropriate first aid for snakebite; (ii) Most children with suspected snakebite presenting to the emergency department were not envenomed; (iii) Envenomation was best diagnosed by clinical features and laboratory investigations, with the Venom Detection Kit being used to determine the appropriate antivenom; (iv) Discharging children directly from the emergency department is not recommended.
- Subjects
WESTERN Australia; SNAKEBITE treatment; SNAKE venom; RESEARCH; RHABDOMYOLYSIS; HOSPITAL emergency services; AGE distribution; RESEARCH methodology; SNAKEBITES; RETROSPECTIVE studies; MEDICAL cooperation; EVALUATION research; SEX distribution; COMPARATIVE studies; ANTIVENINS; BLOOD coagulation disorders
- Publication
Medical Journal of Australia, 1996, Vol 164, Issue 8, p467
- ISSN
0025-729X
- Publication type
journal article
- DOI
10.5694/j.1326-5377.1996.tb122122.x