• William H Shoff.
• Department of Emergency Medicine, University of Pennsylvania Health System, Philadelphia, PA 19106, USA. Electronic address: suzanne613@comcast.net.
• Am J Emerg Med. 2014 May 1;32(5):487.e1-3.

AbstractIndividuals who live and work in the Southeastern coastal range of the 3 US crocodilian carnivores, American alligators, American crocodiles, and caiman, understand the risks of reptile-human encounters. Individuals who live in other parts of the country maybe exposed through contact with exotic pets at private homes, small menageries, or petting zoos or from escaped or abandoned animals. During these encounters, individuals may be severely injured.Emergency medical services, law enforcement, and animal welfare workers in nonhabitat areas are usually not trained in the handling and safe removal of injured individuals from the scene when the reptile is present. The emergency management of large crocodilian injuries is similar to that of other major trauma; however, providers also must take into consideration the significant crush component potentially inflicted by the tremendous bite power and shaking inflicting during attacks by these large reptiles, appropriate antibiotic coverage for less common organisms that inhabit their mouths, and management of possible psychological distress, including posttraumatic stress disorder produced by such an unusual attack. Emergency physicians should support the development of a readily available national database of scientifically collect information on attacks to inform appropriate care and support efforts to explore responsible measures that the USDA Animal and Plant Health Inspection Service and other appropriate local, state, and federal agencies can take to ensure ethical and biologically sustainable management of our large reptiles, which also helps to ensure the safety of the public.

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