Originally Posted by JHC
@Sensei would know better than me but I think allergic reaction was a problem with earlier antivenoms but isn't much of an issue with CroFab or Anavip.
@Sensei would know better than me but I think allergic reaction was a problem with earlier antivenoms but isn't much of an issue with CroFab or Anavip.
There is a big difference between equine-derived whole antibody antivenom and newer Fab fragment antivenom (CroFab) that is now used for domestic crotalidae envenomations. Both whole antibodies and Fab fragments can cause two types of hypersensitivity reactions - early Type I anaphylaxis and a late reaction known as serum sickness (aka Type III or immune complex mediated hypersensitivity reaction). About 20% of people getting whole antibodies will have either anaphylaxis or serum sickness and it can be severe. Interestingly, about the same percentage getting Fab fragments report some reaction with a rash being the most common. Severe reactions with Crofab are rare and were seen in 1 out of 45 people get it in the most recent study. You are still likely to get whole antibody antivenin if you get bitten by an exotic snake or are traveling out of the US.
The best reason not to give CroFab is cost unless it’s a severe envenomation. Each vial is $2200 to the hospital and 3-10X that to the patient or insurer. I’ve seen severe rattlesnake envenomations get 20-30 vials. One kid in FL got 80 vials and a $1.6 million dollar hospital bill - all that to save a future “FL Man...”
Finally, there is an alternative to Crofab called Anavip but it is only FDA approved for rattlesnakes and is marginally less expensive.
Last edited by Sensei; 09-12-2019 at 01:06 PM.
I like my rifles like my women - short, light, fast, brown, and suppressed.
Several things:
1-working and living in the south, I receive training on snake bites regularly
2-most bites are dry
3-any EMT-P worth a f*ck is going to recommend transport to an ED for evaluation by an ER Doc
4-having worked in a very large trauma hospital, Crofab is the antivenin. It covers Rattle snakes, Copperheads and water moccasins.
5-more than likely he wouldn’t have received the antivenin.
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That motherfucker better live up to his potential and get arrested for or killed by something that will give us one helluva laugh.
Those walking/running at night are more at risk of snake bite because many snakes are nocturnal. In daytime snakes are more likely to be active during earlier and later times when temps are cooler. Regardless of time of day, avoid putting hands and feet where you can't see where they will go. In barns or old abandoned houses you can count on having a snake nearby. In my residence I found a shed copperhead skin behind my refrigerator. The serpent lived with me without my knowledge. At night I have found snakes in my carport, storage shed, under vehicles, and in flower beds. More than one person in my area has crawled under a car or truck and come face to face with a snake resting in the suspension. Others have left vehicle windows down and discovered a snake in the car the next day. A friend while piloting a small plane had a snake crawl into his lap. Waking up with a snake in my bed would give me the hebegeebees.
My dad was bitten by a copperhead when he was a teenager, squirrel hunting miles from the truck. That was probably 65+ years ago. He jumped as the snake struck and only got stuck with one fang. He said it was definitely a sucky experience and it was a couple of weeks before he was walking normally.
I’ve come so close to being bitten by cottonmouths and rattle snakes several times. By the way, RI doesn’t have any poisonous snakes!
For comparison, equine origin polyvalent crotalidae antivenin is around $220 per unit hospital cost for animals. Most dogs only get one unit for a copperhead bite and most bites don’t get any antivenin at all. In our area venom induced consumptive coagulopathy and dic are what usually cause deaths from
envenomations. As the cost has come down and quality has gone up I am more likely to give antivenin now versus a decade ago.
Does this 0.1% include R&D for the 999 failed drugs that come with every treatment to make it all the way through FDA approval?
The cost of drugs includes the cost of running the drug company, including R&D and litigation. The fiscal libertarian in me gets a little tired of drug cost discussions.
When I was unassing Texas my gardener got bit on the thumb. One fang from a juvenile copperhead. I wrapped a rubber band around the base of his thumb and drove him to the hospital and sat with him for a few hours until his wife got off work. It sucked out loud for him; he lost a pretty good chunk out of his thumb and two week’s work. He got the hospital bill mitigated but I did wind up paying him as if he’d worked for me for a solid week.
I miss the barbecue but not the fucking snakes.
Last edited by JAD; 09-13-2019 at 02:19 AM.
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Applying tq’s to snake bites is not recommended because the majority of venom is highly cytotoxic and restricting the blood flow keeps the venom from diluting and increases the severity of tissue damage.
Last edited by Caballoflaco; 09-13-2019 at 04:22 AM.
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