Rattlesnake Envenomations in Children: Are They More Severe Than Envenomations in Adults?

Abstract

Specific Aims: The aim of this study is to compare characteristics, clinical treatments, severity, and outcomes in pediatric rattlesnake envenomation cases as compared to adults to better understand the current differences in envenomation management between the two populations. Methods: This is a retrospective descriptive study utilizing the electronic medical records (EMR) from the Arizona Poison and Drug Information Center (APDIC). Rattlesnake bites requiring care at a healthcare facility and followed to the outcome by the APDIC between January 1, 2017 and September 30, 2020 were included. Dry bites, cases transferred to another poison center, cases where the patient left against medical advice, or otherwise unable to be followed to the outcome were excluded. Information obtained for analysis include patient demographics, location of bite on body, time of bite, whether the patient received anti-venom, if the patient experienced coagulopathy and other symptoms. Main Results There was no significant difference in the amount of antivenom vials used between the adult and pediatric groups (χ2(1) = 8.520, p = 0.503, with a mean rank score of 229.25 for adults and 240.62 for pediatrics). Also, there was no significant difference between the mean Abbreviated Snakebite Severity Score between both the adult and pediatric groups (mean; 3.1, 3.4, respectively, p = 0.373). Other symptoms that were evaluated showed no significant differences in coagulopathy, late coagulopathy, peak edema, and hematologic toxicities. Conclusions The comparison of characteristics, clinical treatments, severity, and outcomes in pediatric to adult rattlesnake envenomations, showed no significant differences in envenomation management between the two populations.