Tracheal Intubation Prevented With Administration of Fab Antivenom After Severe Crotaline Envenomation

Abstract Background: Crotaline snake envenomations are common, but severe crotaline envenomations are infrequent. Death from severe envenomation is usually from upper airway edema and respiratory failure. Published reports of severe respiratory compromise and anaphylactoid reactions are rare. Curren...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of emergency medicine 2010-07, Vol.39 (1), p.e81-e83
Main Authors: Bebarta, Vikhyat S., MD, Ferre, Robinson M., MD, Peck, Michael, MD
Format: Article
Language:English
Subjects:
Adult
Animals
Antivenins - administration & dosage
Antivenins - therapeutic use
antivenom
crotaline
Emergency
Humans
Immunoglobulin Fab Fragments
Immunoglobulin Fragments - administration & dosage
Immunoglobulin Fragments - therapeutic use
intubation
Intubation, Intratracheal
Male
severe envenomation
Snake Bites - complications
Snake Bites - therapy
snakebite
Viperidae
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background: Crotaline snake envenomations are common, but severe crotaline envenomations are infrequent. Death from severe envenomation is usually from upper airway edema and respiratory failure. Published reports of severe respiratory compromise and anaphylactoid reactions are rare. Currently, FabAV (Crotalidae polyvalent immune Fab [Ovine] [CroFab]) is the mainstay of crotaline envenomation treatment; however, FabAV has been approved for only mild and moderate envenomations. Case report: We describe a case of a male with severe systemic effects and airway compromise after crotaline envenomation. The patient's systemic effects and upper airway edema substantially improved after antivenom infusion and before epinephrine administration. Endotracheal intubation was averted, clinical deterioration was avoided, and improvement occurred after prompt FabAV use. Conclusion: Fab antivenom likely prevented endotracheal intubation in our case of severe crotaline envenomation.
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2007.11.096