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AFITLewis
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Posted: 10/16/2011 3:53:34 PM
It seems like i see an awful lot of stories that start with " the first hospital the person was taken to did not have any anti venom . So the patient was flown to a hospital that has it "


By the time they make it to the second hospital the venom has started to do serious damage to the person. Just seems real dumb to me.
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Posted: 10/16/2011 3:55:29 PM
[Last Edit: 10/16/2011 3:55:40 PM by nick89302]

Cost vs. Benefit
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Posted: 10/16/2011 3:55:46 PM
It's expensive, it has a limited shelf-life, and it's hardly ever needed.
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Posted: 10/16/2011 3:56:39 PM
If you get bit by a Coral Snake down here, you are screwed. All the antivenin is gone.
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Posted: 10/16/2011 3:57:02 PM
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


This
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Posted: 10/16/2011 3:57:18 PM
Same reason any store dosen't stock everything.
substandard
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Posted: 10/16/2011 3:59:27 PM

Originally Posted By DamascusKnifemaker:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


This

In Ireland it is the law that all food stores and drug stores keep anti-venom on hand for all indigenous snakes.















(waiting, waiting.....)
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Posted: 10/16/2011 3:59:43 PM
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TheGrayMan
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Posted: 10/16/2011 4:06:51 PM
[Last Edit: 10/16/2011 4:07:37 PM by TheGrayMan]
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


Yep... like $2000-per-vial expensive... and a symptomatic bite will frequently require 10-12 vials minimum... some require much more.

And plenty of people who get themselves bitten? A lot of them are uninsured. Also, if they have an upper-extremity bite, they're also frequently drunk.

I don't know what the reimbursement is like for a snake-bite injury in an insured patient (it's been a while since I've had one, frankly...), but I wouldn't be surprised if the hospital thought it was too expensive to keep the stuff on-hand. They might be better-off financially to transfer that patient to a center that does stock the anti-venom, so that the larger facility can eat the loss.

In my worst month, I treated three symptomatic rattlesnake bites, and since I was on the P&T committee for the hospital, I was treated to a lot of complaining from the pharmacy folks.

It seems I blew their budget for the month.
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PrivateContactor
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Posted: 10/16/2011 4:08:21 PM
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


Venom One in Miami FL has pretty much the largest collection of antivenom in the US.....Loma Linda, in CA is another source. Some zoos that do research with cyber toxic snakes have a supply available. When I kept my elapids (coastal taipans, common browns, & king browns) Venom One, had some antivenom, however at the time they only had enough for a half-dosage (aka I would have been screwed) . Venom is utilized to produce anti-venom (produced differently depending on species). Venom can cost up to $3000 per microgram, which sufficient to say is very cost prohibited. Keeping a local variety of antivenom available is a good idea for larger hospitals, but for smaller ones it is just not cost effective. If you are outdoors in snake country, bring along an Extractor kit, and learn how to do a pressure bandage, which if quickly and properly applied can save your life, even on the deadliest of elapids. It will at least buy you a little time until you can get to medical help.

-Private Contractor-

Jarhead08
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Posted: 10/16/2011 4:11:25 PM

Originally Posted By substandard:

Originally Posted By DamascusKnifemaker:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


This

In Ireland it is the law that all food stores and drug stores keep anti-venom on hand for all indigenous snakes.















(waiting, waiting.....)

Saint Patrick sees what you did there.



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AFITLewis
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Posted: 10/16/2011 4:13:43 PM
Originally Posted By WildBoar:
If you get bit by a Coral Snake down here, you are screwed. All the antivenin is gone.

Sounds like a nice business venture.
AFITLewis
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Posted: 10/16/2011 4:15:59 PM
Originally Posted By TheGrayMan:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


Yep... like $2000-per-vial expensive... and a symptomatic bite will frequently require 10-12 vials minimum... some require much more.

And plenty of people who get themselves bitten? A lot of them are uninsured. Also, if they have an upper-extremity bite, they're also frequently drunk.

I don't know what the reimbursement is like for a snake-bite injury in an insured patient (it's been a while since I've had one, frankly...), but I wouldn't be surprised if the hospital thought it was too expensive to keep the stuff on-hand. They might be better-off financially to transfer that patient to a center that does stock the anti-venom, so that the larger facility can eat the loss.

In my worst month, I treated three symptomatic rattlesnake bites, and since I was on the P&T committee for the hospital, I was treated to a lot of complaining from the pharmacy folks.

It seems I blew their budget for the month.


Funny how everything comes down to money .
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Posted: 10/16/2011 4:18:46 PM
Originally Posted By PrivateContactor:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


Venom One in Miami FL has pretty much the largest collection of antivenom in the US.....Loma Linda, in CA is another source. Some zoos that do research with cyber toxic snakes have a supply available. When I kept my elapids (coastal taipans, common browns, & king browns) Venom One, had some antivenom, however at the time they only had enough for a half-dosage (aka I would have been screwed) . Venom is utilized to produce anti-venom (produced differently depending on species). Venom can cost up to $3000 per microgram, which sufficient to say is very cost prohibited. Keeping a local variety of antivenom available is a good idea for larger hospitals, but for smaller ones it is just not cost effective. If you are outdoors in snake country, bring along an Extractor kit, and learn how to do a pressure bandage, which if quickly and properly applied can save your life, even on the deadliest of elapids. It will at least buy you a little time until you can get to medical help.

-Private Contractor-



I'm not so sure I'd spend money on those.
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fatalerror113
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Posted: 10/16/2011 4:19:03 PM

Originally Posted By Jarhead08:

Originally Posted By substandard:

Originally Posted By DamascusKnifemaker:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


This

In Ireland it is the law that all food stores and drug stores keep anti-venom on hand for all indigenous snakes.















(waiting, waiting.....)

Saint Patrick sees what you did there.


I'll just leave this here.

http://nationalzoo.si.edu/animals/reptilesamphibians/newsevents/irelandsnakes.cfm
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Posted: 10/16/2011 4:20:01 PM
I had no idea that anti-venom was so expensive. Interesting... Remind me to not get bit by any snakes, I don't think I have $20,000 available on my FSA.
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Posted: 10/16/2011 4:21:05 PM

Originally Posted By AFITLewis:
Originally Posted By WildBoar:
If you get bit by a Coral Snake down here, you are screwed. All the antivenin is gone.

Sounds like a nice business venture.

It does, doesn't it? Right up until nobody wants to pay for your wonderful product.

Best stick to helping old geezers get it up. They'll pay for that.
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Posted: 10/16/2011 4:26:04 PM
Originally Posted By Polupharmakos:

Originally Posted By AFITLewis:
Originally Posted By WildBoar:
If you get bit by a Coral Snake down here, you are screwed. All the antivenin is gone.

Sounds like a nice business venture.

It does, doesn't it? Right up until nobody wants to pay for your wonderful product.

Best stick to helping old geezers get it up. They'll pay for that.


Maybe use the blue pills as snake charmer bait...snake eats the pill, stiffens up for a few hours, makes them easier to find and catch when they can't slither and crawl.
AFITLewis
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Posted: 10/16/2011 4:26:22 PM
Originally Posted By Polupharmakos:

Originally Posted By AFITLewis:
Originally Posted By WildBoar:
If you get bit by a Coral Snake down here, you are screwed. All the antivenin is gone.

Sounds like a nice business venture.

It does, doesn't it? Right up until nobody wants to pay for your wonderful product.

Best stick to helping old geezers get it up. They'll pay for that.

I bet TheGrayMan knows all about those cases.

































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Posted: 10/16/2011 4:29:16 PM
Originally Posted By TheGrayMan:
Originally Posted By PrivateContactor:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


Venom One in Miami FL has pretty much the largest collection of antivenom in the US.....Loma Linda, in CA is another source. Some zoos that do research with cyber toxic snakes have a supply available. When I kept my elapids (coastal taipans, common browns, & king browns) Venom One, had some antivenom, however at the time they only had enough for a half-dosage (aka I would have been screwed) . Venom is utilized to produce anti-venom (produced differently depending on species). Venom can cost up to $3000 per microgram, which sufficient to say is very cost prohibited. Keeping a local variety of antivenom available is a good idea for larger hospitals, but for smaller ones it is just not cost effective. If you are outdoors in snake country, bring along an Extractor kit, and learn how to do a pressure bandage, which if quickly and properly applied can save your life, even on the deadliest of elapids. It will at least buy you a little time until you can get to medical help.

-Private Contractor-




I'm not so sure I'd spend money on those.


I have always carried one, but never used one, so I can not attest to their effectiveness. I have heard they are better than nothing, but likewise I have also heard that they were just cleverly marketed where there are few other products available. Do you have any personal info, I replace mine every 3-4 years and have 2-3 of them in various packs, if it is money down the drain, please let me know.

-PC-

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Posted: 10/16/2011 4:29:38 PM
If you get bit by a poisonous snake the best thing you can do is hit the area with a high voltage shock such as from a stun gun, cattle prod, grill igniter, or from the ignition system from a gasoline engine. Strangely enough it is much more effective than antivenom. They believe the high voltage breaks down the venom. A high voltage shock only works though if you can do it before the venom has a chance to spread.
"It will be of little avail to the people that the laws are made by men of their own choice if the laws be so voluminous that they cannot be read, or so incoherent that they cannot be understood." – James Madison<
AFITLewis
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Posted: 10/16/2011 4:34:01 PM
Originally Posted By scottedward58:
If you get bit by a poisonous snake the best thing you can do is hit the area with a high voltage shock such as from a stun gun, cattle prod, grill igniter, or from the ignition system from a gasoline engine. Strangely enough it is much more effective than antivenom. They believe the high voltage breaks down the venom. A high voltage shock only works though if you can do it before the venom has a chance to spread.


Ill stick with the anti venom.
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Posted: 10/16/2011 4:34:59 PM
Originally Posted By WildBoar:
If you get bit by a Coral Snake down here, you are screwed. All the antivenin is gone.


Actually coral snake venom is neurotoxic only, it has no hemotoxic or cytotoxic components that destroy tissue like most other snake venoms have. You die when your brain can't signal your heart to beat or tell your lungs to inhale and exhale. Why spend huge amounts of money on an expensive drug with only one use when you can just put the guy on a heart-lung machine that has many other uses until the venom clears out of his system and he can breathe by himself again?
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Posted: 10/16/2011 4:36:27 PM
[Last Edit: 10/16/2011 4:41:00 PM by jsnappa]
Because only stupid people get bit by snakes, in my experience.
They never have insurance and are always wearing a sleevless shirt and camo ball cap - not that there's anything wrong with that.
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Posted: 10/16/2011 4:39:53 PM
Look at the majority of snake bite victims.. they fall into 3 categories 1) Those who keep snakes for a living (generally uninsured) 2) Hold my beer and watch this.. I'll get that snake (generally uninsured) 3) Hikers (I'd say 50/50% chance of insurance). No insurance means no reimbursement for the hospital and means no incentive to stock time limited high cost low use supplies.

In 2.5 years in the ER I've seen 1 snake bite.. the story goes a son was out near his trailer park and picked up a snake and noticed it was a coral snake. The son immediately placed it down and told his mother. His mother decided she was going to extricate the snake which then strikes her. She then has the trailer park mentality to ease the pain by taking twice her dose of oxycodone and chug a few beers while waiting for EMS to pick her up. If the FDA had not extended the expiration date on the coral snake antivenim she would have ended up on a ventilator for 2 weeks till her body flushed it out.

For the 25-50 coral snake bites in the USA per year the ER doctors are gonna have some tough news to bear when they explain if it had happened in Mexico you'd probably leave in a day but since we are safer and cannot license critical medication here they will be here for 2-3 weeks and be inherently more at risk for things such as pneumonia and sepsis.
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Posted: 10/16/2011 4:47:13 PM
Originally Posted By AFITLewis:
Originally Posted By TheGrayMan:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


Yep... like $2000-per-vial expensive... and a symptomatic bite will frequently require 10-12 vials minimum... some require much more.

And plenty of people who get themselves bitten? A lot of them are uninsured. Also, if they have an upper-extremity bite, they're also frequently drunk.

I don't know what the reimbursement is like for a snake-bite injury in an insured patient (it's been a while since I've had one, frankly...), but I wouldn't be surprised if the hospital thought it was too expensive to keep the stuff on-hand. They might be better-off financially to transfer that patient to a center that does stock the anti-venom, so that the larger facility can eat the loss.

In my worst month, I treated three symptomatic rattlesnake bites, and since I was on the P&T committee for the hospital, I was treated to a lot of complaining from the pharmacy folks.

It seems I blew their budget for the month.


Funny how everything comes down to money .


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Posted: 10/16/2011 4:58:06 PM
[Last Edit: 10/16/2011 5:05:28 PM by scottedward58]
Originally Posted By AFITLewis:
Originally Posted By scottedward58:
If you get bit by a poisonous snake the best thing you can do is hit the area with a high voltage shock such as from a stun gun, cattle prod, grill igniter, or from the ignition system from a gasoline engine. Strangely enough it is much more effective than antivenom. They believe the high voltage breaks down the venom. A high voltage shock only works though if you can do it before the venom has a chance to spread.


Ill stick with the anti venom.


It doesn't have to be one or the other, the high voltage shock is a first aid treatment but when the high voltage shock treatment is used properly it eliminates the need for antivenom. Do some research into it yourself before discounting something that could save your life. People carry those stupid snake bite kits that are supposed to suck the venom out even though they have been proved to be virtually ineffective, so why not do something that has actually been shown to work especially when it is so simple. A grill igniter is about the same cost as a snake bite kit, there is no reason not to do it.
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Posted: 10/16/2011 5:02:54 PM
Originally Posted By scottedward58:
Originally Posted By AFITLewis:
Originally Posted By scottedward58:
If you get bit by a poisonous snake the best thing you can do is hit the area with a high voltage shock such as from a stun gun, cattle prod, grill igniter, or from the ignition system from a gasoline engine. Strangely enough it is much more effective than antivenom. They believe the high voltage breaks down the venom. A high voltage shock only works though if you can do it before the venom has a chance to spread.


Ill stick with the anti venom.


It doesn't have to be one or the other, the high voltage shock is a first aid treatment but when the high voltage shock treatment is used properly it eliminates the need for antivenom. Do some research into it yourself before discounting something that could save your life.


There's research and then there's research. Some purports to show the voltage works but there have been NO scientific studies to show that is true...my guess is it is BS and several studies have indicated that as well, but people persist in believing it.

Trust the anti venom

Run Fast...Bite Hard!
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Posted: 10/16/2011 5:03:20 PM
[Last Edit: 10/16/2011 5:04:25 PM by thehardmaster]
the er i work in was one of the first to use anascorp (scorpion sting antivenom), because we were one of the research hospitals. Now the research has ended, and the medicine is available commercially. As a result, now the patient gets billed if we use it. $20,000 is a typical bill just for the anti venom itself. Sucks if you are private pay!

Most scorpion stings do not require anti-venom. But there have been numerous commercials on the radio and tv letting people know anascorp is now available. As a result, people are coming in droves for scorpion stings.

Cha CHING!

ETA, Crofab, which is for rattlesnake bites , is even more expensive. (if i am not mistaken)
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Posted: 10/16/2011 5:09:15 PM
My understanding was most anti-venom types were in short supply, or simply don't exist in any meaningful quantity.
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Posted: 10/16/2011 5:11:14 PM
I'll just make that fucking snake bite me twice. That should work, right?
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Posted: 10/16/2011 5:11:47 PM
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.




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Posted: 10/16/2011 5:13:47 PM
Originally Posted By ikor:
Originally Posted By AFITLewis:
Originally Posted By TheGrayMan:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


Yep... like $2000-per-vial expensive... and a symptomatic bite will frequently require 10-12 vials minimum... some require much more.

And plenty of people who get themselves bitten? A lot of them are uninsured. Also, if they have an upper-extremity bite, they're also frequently drunk.

I don't know what the reimbursement is like for a snake-bite injury in an insured patient (it's been a while since I've had one, frankly...), but I wouldn't be surprised if the hospital thought it was too expensive to keep the stuff on-hand. They might be better-off financially to transfer that patient to a center that does stock the anti-venom, so that the larger facility can eat the loss.

In my worst month, I treated three symptomatic rattlesnake bites, and since I was on the P&T committee for the hospital, I was treated to a lot of complaining from the pharmacy folks.

It seems I blew their budget for the month.


Funny how everything comes down to money .


Wall Street Bastages!



I worked in a hospital pharmacy until recently. I believe the last lot of true antivenom went out of date several years back, and that was after having the expiration date extended. Wyeth was the only company making antivenoms and ceased production, due to cost consideratiions.

The only product out there now is CroFab which works by a different mechanism than the antivenoms, end result being the same, less tissue damage, and with far fewer allergy problems than the old antivenoms which were made from the plasma from horses which had been injected with venom to produce antibodies to the venom. You were injecting a portion of the horse blood into a human, so severe allergy problems were not uncommon.

We in some years treated 6-8 patients for pit viper evenomation.. It's been a bit over 40 years ago, when I was in the USAF, we treated one child over in Georgia for coral snake bite, at that time we had antivenoms for pit vipers, coral snakes, and black widow spiders, non of which are available today.
TheGrayMan
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Posted: 10/16/2011 5:17:41 PM
[Last Edit: 10/16/2011 5:19:02 PM by TheGrayMan]
Originally Posted By scottedward58:
If you get bit by a poisonous snake the best thing you can do is hit the area with a high voltage shock such as from a stun gun, cattle prod, grill igniter, or from the ignition system from a gasoline engine. Strangely enough it is much more effective than antivenom. They believe the high voltage breaks down the venom. A high voltage shock only works though if you can do it before the venom has a chance to spread.


So I can get burns and rhabdo... in addition to the muscle damage the venom itself is causing?

No thanks.

ETA @privatecontractor: the data on the Venom extractor devices is really poor. Where it has been studied (in pig and human models), it extracts little, if any, venom... and can actually worsen necrosis. I wouldn't use one... but people are free to use what they want.
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Posted: 10/16/2011 5:19:01 PM
Cost.

Anti Venom does not keep for very long and must be constantly rotated out.
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Posted: 10/16/2011 5:22:38 PM
Originally Posted By TheGrayMan:
Originally Posted By PrivateContactor:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


Venom One in Miami FL has pretty much the largest collection of antivenom in the US.....Loma Linda, in CA is another source. Some zoos that do research with cyber toxic snakes have a supply available. When I kept my elapids (coastal taipans, common browns, & king browns) Venom One, had some antivenom, however at the time they only had enough for a half-dosage (aka I would have been screwed) . Venom is utilized to produce anti-venom (produced differently depending on species). Venom can cost up to $3000 per microgram, which sufficient to say is very cost prohibited. Keeping a local variety of antivenom available is a good idea for larger hospitals, but for smaller ones it is just not cost effective. If you are outdoors in snake country, bring along an Extractor kit, and learn how to do a pressure bandage, which if quickly and properly applied can save your life, even on the deadliest of elapids. It will at least buy you a little time until you can get to medical help.

-Private Contractor-



I'm not so sure I'd spend money on those.


In my medic class we were taught that those and other old methods like sucking out the venom were worthless.
TheGrayMan
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Posted: 10/16/2011 5:26:39 PM
Originally Posted By Banjaxed:
Originally Posted By TheGrayMan:
Originally Posted By PrivateContactor:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


Venom One in Miami FL has pretty much the largest collection of antivenom in the US.....Loma Linda, in CA is another source. Some zoos that do research with cyber toxic snakes have a supply available. When I kept my elapids (coastal taipans, common browns, & king browns) Venom One, had some antivenom, however at the time they only had enough for a half-dosage (aka I would have been screwed) . Venom is utilized to produce anti-venom (produced differently depending on species). Venom can cost up to $3000 per microgram, which sufficient to say is very cost prohibited. Keeping a local variety of antivenom available is a good idea for larger hospitals, but for smaller ones it is just not cost effective. If you are outdoors in snake country, bring along an Extractor kit, and learn how to do a pressure bandage, which if quickly and properly applied can save your life, even on the deadliest of elapids. It will at least buy you a little time until you can get to medical help.

-Private Contractor-



I'm not so sure I'd spend money on those.


In my medic class we were taught that those and other old methods like sucking out the venom were worthless.


+1

The cutting-X's-and-sucking-out-the-venom thing is worse than worthless... it actually causes further harm.
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AFITLewis
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Posted: 10/16/2011 5:27:16 PM
Originally Posted By ikor:
Originally Posted By AFITLewis:
Originally Posted By TheGrayMan:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


Yep... like $2000-per-vial expensive... and a symptomatic bite will frequently require 10-12 vials minimum... some require much more.

And plenty of people who get themselves bitten? A lot of them are uninsured. Also, if they have an upper-extremity bite, they're also frequently drunk.

I don't know what the reimbursement is like for a snake-bite injury in an insured patient (it's been a while since I've had one, frankly...), but I wouldn't be surprised if the hospital thought it was too expensive to keep the stuff on-hand. They might be better-off financially to transfer that patient to a center that does stock the anti-venom, so that the larger facility can eat the loss.

In my worst month, I treated three symptomatic rattlesnake bites, and since I was on the P&T committee for the hospital, I was treated to a lot of complaining from the pharmacy folks.

It seems I blew their budget for the month.


Funny how everything comes down to money .


Wall Street Bastages!



Ok. That is quite the stretch.
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Posted: 10/16/2011 5:27:41 PM
Originally Posted By jsnappa:
Because only stupid people get bit by snakes, in my experience.
They never have insurance and are always wearing a sleevless shirt and camo ball cap - not that there's anything wrong with that.


The only snake bite patient I have ever worked was bitten in the arm by a Eastern Rattler. He was rock climbing and blindly reached over a ledge disturbing a Rattler who was sunning it's self. Took a good fall and broke a lot of stuff in the process. Laid there for over an hour before being discovered. He lost the arm when all was said and done. Not all snake bites are a "Hold my beer and watch this" kind of thing.
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Posted: 10/16/2011 5:31:48 PM
Originally Posted By jsnappa:
Because only stupid people get bit by snakes, in my experience.
They never have insurance and are always wearing a sleevless shirt and camo ball cap - not that there's anything wrong with that.


We had a lady walking in her back yard in sandals get tagged by a small water moccasin one night. Her husband was right behind her and was able to kill it and bring it in so it could be ID'ed. She has some serious swelling going on in her foot and we got her transferred out pretty quickly.
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Posted: 10/16/2011 5:39:18 PM
Originally Posted By WildBoar:
If you get bit by a Coral Snake down here, you are screwed. All the antivenin is gone.


Where's here? Florida as a whole? Or your area?

Shands at UF has some on hand, last coral snake bite we transported, they indicated to us they had two vials on hand, which is what they normally keep on hand for coral snakes... the patent took both!

If more was needed....shandscare would have either hauled ass to shands jacks or to tallahasse to get more.

Miami-dade fire rescue also has 'Venom-1".....Thank god for these guys!
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Posted: 10/16/2011 5:39:43 PM
Originally Posted By TheGrayMan:
Originally Posted By Banjaxed:
Originally Posted By TheGrayMan:
Originally Posted By PrivateContactor:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


Venom One in Miami FL has pretty much the largest collection of antivenom in the US.....Loma Linda, in CA is another source. Some zoos that do research with cyber toxic snakes have a supply available. When I kept my elapids (coastal taipans, common browns, & king browns) Venom One, had some antivenom, however at the time they only had enough for a half-dosage (aka I would have been screwed) . Venom is utilized to produce anti-venom (produced differently depending on species). Venom can cost up to $3000 per microgram, which sufficient to say is very cost prohibited. Keeping a local variety of antivenom available is a good idea for larger hospitals, but for smaller ones it is just not cost effective. If you are outdoors in snake country, bring along an Extractor kit, and learn how to do a pressure bandage, which if quickly and properly applied can save your life, even on the deadliest of elapids. It will at least buy you a little time until you can get to medical help.

-Private Contractor-



I'm not so sure I'd spend money on those.


In my medic class we were taught that those and other old methods like sucking out the venom were worthless.


+1

The cutting-X's-and-sucking-out-the-venom thing is worse than worthless... it actually causes further harm.


I was going to say that no fire department, ambulance company, or ER that I am aware of carry those. Take that as your answer.
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Posted: 10/16/2011 5:42:40 PM
Originally Posted By TheGrayMan:
And plenty of people who get themselves bitten? A lot of them are uninsured. Also, if they have an upper-extremity bite, they're also frequently drunk.



This is the god honest truth....Out of the 9 years of being in FR, I've only been to two venomous snake bites, both Coral, both patients drunk, both patients uninsured!
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Posted: 10/16/2011 5:42:50 PM
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


+1 In addition I understand that most people are allergic to the anti venom.

I don't always report on ARFCOM, but when I do, I use #AttackWatch
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Posted: 10/16/2011 5:45:38 PM
Originally Posted By Banjaxed:
Originally Posted By TheGrayMan:
Originally Posted By PrivateContactor:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


Venom One in Miami FL has pretty much the largest collection of antivenom in the US.....Loma Linda, in CA is another source. Some zoos that do research with cyber toxic snakes have a supply available. When I kept my elapids (coastal taipans, common browns, & king browns) Venom One, had some antivenom, however at the time they only had enough for a half-dosage (aka I would have been screwed) . Venom is utilized to produce anti-venom (produced differently depending on species). Venom can cost up to $3000 per microgram, which sufficient to say is very cost prohibited. Keeping a local variety of antivenom available is a good idea for larger hospitals, but for smaller ones it is just not cost effective. If you are outdoors in snake country, bring along an Extractor kit, and learn how to do a pressure bandage, which if quickly and properly applied can save your life, even on the deadliest of elapids. It will at least buy you a little time until you can get to medical help.

-Private Contractor-



I'm not so sure I'd spend money on those.


In my medic class we were taught that those and other old methods like sucking out the venom were worthless.


Yep. Wilderness medicine protocol was to minimize the movement (hence circulation) of the pt, keep the wound lower than the heart and get them to hospital ASAP.

Not a lot smarter but another year old...
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Posted: 10/16/2011 5:53:52 PM
Most people are smart enough to not get bit. Not carrying anti-venom allows natural selection to work it's magic.
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Posted: 10/16/2011 5:56:39 PM
[Last Edit: 10/16/2011 6:03:12 PM by TheGrayMan]
Originally Posted By jerrwhy01:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


+1 In addition I understand that most people are allergic to the anti venom.



No... the CroFAB is actually very well-tolerated. I've yet to see a serious reaction to it.

That's in direct contrast to the old polyvalent horse serum (the Wyeth antivenom that was previously mentioned). That stuff was nasty... very antigenic, and a higher rate of anaphylaxis.

Few things suck worse than being allergic to the friggin' antidote.

ETA: I once took care of a teenager who took a truly heroic quantity of tylenol, and ended up being allergic to the antidote (N-acetylcysteine). And by "allergic," I don't mean just the itchy-scratchies... he swelled/hived-up immedately and dropped his blood pressure with the first dose... while pumping him full of epi/benadryl/steroids, we all looked at one another and somebody said "F*ck... what in the hell do we do now??"

Some people are just unlucky.
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Posted: 10/16/2011 6:11:06 PM
Originally Posted By TheGrayMan:
Originally Posted By jerrwhy01:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


+1 In addition I understand that most people are allergic to the anti venom.



No... the CroFAB is actually very well-tolerated. I've yet to see a serious reaction to it.

That's in direct contrast to the old polyvalent horse serum (the Wyeth antivenom that was previously mentioned). That stuff was nasty... very antigenic, and a higher rate of anaphylaxis.

Few things suck worse than being allergic to the friggin' antidote.

ETA: I once took care of a teenager who took a truly heroic quantity of tylenol, and ended up being allergic to the antidote (N-acetylcysteine). And by "allergic," I don't mean just the itchy-scratchies... he swelled/hived-up immedately and dropped his blood pressure with the first dose... while pumping him full of epi/benadryl/steroids, we all looked at one another and somebody said "F*ck... what in the hell do we do now??"

Some people are just unlucky.


I also, have never heard of a negative reaction to CroFab. But for crotalid species that also contain neurotoxic proteins, such as the mojave? What is used....stil CroFab?....or in conjunction with other medicines to try and head off the neurological toxins?

Related to the subject.....for those serious about herpetology... Bill Haast past away this last summer.....this is the first I have heard of this, his contribution to the science was phenomenal, even though he liked to show boat around, his knowledge was incredible....started injecting himself with cobra venom long ago....bitten more than 172 times in his life....and lived to the ripe age of 100... He will be missed.

-Private Contractor-
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Posted: 10/16/2011 6:16:49 PM
I administered CroFAB once to a guy who was bitten out in the Utah west desert. It was a mild bite, but he still needed 6 vials of CroFAB. The pharmacist told me his cost was $3,000/vial and we gave 6. I've read about cases of people being given many more than that.

The stuff out-dates long before you're likely to use it. 6 vials was every drop I had in the county. We only had 3 in the hospital, and had a deputy bring over the other 3 vials from the other side of the county. If he'd needed any more, we'd have had to transfer.
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Posted: 10/16/2011 6:20:32 PM
Originally Posted By PrivateContactor:
Originally Posted By TheGrayMan:
Originally Posted By jerrwhy01:
Originally Posted By Rodent:
It's expensive, it has a limited shelf-life, and it's hardly ever needed.


+1 In addition I understand that most people are allergic to the anti venom.



No... the CroFAB is actually very well-tolerated. I've yet to see a serious reaction to it.

That's in direct contrast to the old polyvalent horse serum (the Wyeth antivenom that was previously mentioned). That stuff was nasty... very antigenic, and a higher rate of anaphylaxis.

Few things suck worse than being allergic to the friggin' antidote.

ETA: I once took care of a teenager who took a truly heroic quantity of tylenol, and ended up being allergic to the antidote (N-acetylcysteine). And by "allergic," I don't mean just the itchy-scratchies... he swelled/hived-up immedately and dropped his blood pressure with the first dose... while pumping him full of epi/benadryl/steroids, we all looked at one another and somebody said "F*ck... what in the hell do we do now??"

Some people are just unlucky.


I also, have never heard of a negative reaction to CroFab. But for crotalid species that also contain neurotoxic proteins, such as the mojave? What is used....stil CroFab?....or in conjunction with other medicines to try and head off the neurological toxins?

Related to the subject.....for those serious about herpetology... Bill Haast past away this last summer.....this is the first I have heard of this, his contribution to the science was phenomenal, even though he liked to show boat around, his knowledge was incredible....started injecting himself with cobra venom long ago....bitten more than 172 times in his life....and lived to the ripe age of 100... He will be missed.

-Private Contractor-


We only use the CroFab... but I've never treated a mojave bite... so there may be something else they do for that... but I'm sure CroFab is part of the protocol regardless.
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Posted: 10/16/2011 6:27:46 PM
A little truth and a lot of BS here.

  • Best first aid for snake bite: "Wilderness medicine protocol was is to minimize the movement (hence circulation) of the pt, keep the wound lower than the heart and get them to hospital ASAP." Write down victim's name, social security number, and time of bite and make sure this info gets to the hospital..

  • CroFab is made in the USA and is an excellent well-tolerated antivenin . It is what most hospitals in the United States have because it is used to treat the snake bites (Crotalidae) commonly encountered in the United States..

  • Electroshock is not considered effective for snake bites by the medical and medical research community.

  • I am pretty sure that Black Widow Spider Antivenin is still made in the United States.
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