Re: Crotalus envenomation

[Guest guest]

's reply is most interesting. Tucson is, from all I can tell, totally

antivenin and anti-surgical exploration unless fasciotomy is required.

However, the current shortage of CroFab may cause a change in approach here,

but I do not see them cutting and slicing. Here they DO medivac them either

to Tucson or Phoenix, but then that's another story, isn't it?

gg

E. Gandy, JD, LP

4250 East Aquarius Drive

Tucson, AZ 85718

520 299-4448 home and fax (call before sending fax)

903 530-9826 cell

[Guest guest]

On Thu, 11 Apr 2002 03:18:49 EDT wegandy@... writes:

> Here they DO medivac them either

> to Tucson or Phoenix, but then that's another story, isn't it?

Appropriate for some of the distances involved out there. I flew a 4 year

old female that had sustained a single envenomated Diamondback

Rattlesnake bite to the later foot from Polaka (Hopi Reservation) to PHX

Children's. She had received the antivenin test dose and we started the

drip on our pump tubing. During the 55 minute flight, her ankle girth

increased approx 1.5 cm and mid calf girth 2.0 cm. Normal for enthnicity

coloration deteriorated to dark purple. Pedal pulses went from palpable

2/4 to doppler only with 4 sec cap refill. The pedi trauma surgeon

elected to do a fasciotomy. We followed up on the child the next day and

she had palpable pulses and <2 sec. cap refill. Unsure of long term

results as I went on vacation and by the time I got back, she had been

discharged.

An interesting thing to note- in the year and a half I flew out there,

she was the only snakebite our company transported (we had first

transport call for both the Navajo and Hopi Nations) and she didn't live

in the Hopi Nation (she lived in PHX; up there visiting cousins). There

are such strong religious and social taboos regarding snakes, they are

given wide berth.

God, bless America

No evil can happen to a good man, either in life or after death.

Plato (428 BC - 348 BC), Dialogues, Apology

Larry RN NREMTP