• Muhammad H Nazim, Sanjay Gupta, Syed Hashmi, Jamshed Zuberi, Alison Wilson, Lawrence Roberts, and Kamran Karimi.
• Department of Surgery, Division of Trauma and Critical Care, West Virginia University, Morgantown. , USA.
• W V Med J. 2008 Sep 1; 104 (5): 30-4.

AbstractVenomous snakebites are a rare but dangerous and potentially deadly condition in the U.S.. Most bites in the U. S. result from envenomation with snakes of the family Viperidae, subfamily Crotalinae, which includes rattlesnakes and copperheads. Treatment includes a comprehensive work-up to look for possible hematologic, neurologic, renal, and cardiovascular abnormalities, local wound care, systemic antivenom administration, tetanus prophylaxis, antibiotics in the presence of infection and surgical treatment if needed, which may include debridement, fasciotomy and rarely amputation. All these patients should be observed for a minimum of 8 hours. Any evidence of envenomation mandates a minimum of 24 hours of in-hospital observation. A grading system to classify the severity of envenomation is described. The most commonly used antivenom in the U.S. is CroFab, which has a much lower incidence of acute or delayed allergic reactions compared to the older antivenoms. When allergic reactions do occur, they are usually of mild to moderate severity. With the improved risk-benefit ratio of CroFab, antivenom is indicated with any grade of envenomation. In this a retrospective study, we will review our experience with 25 snakebite victims admitted to the West Virginia University over a five years period.

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