The treatment of crotalid XXXX without antivenin.

@entity1 @entity39 @entity935 @entity1503 @entity2048 @entity116 @entity551 @entity5900
Eighty-one @entity1 were treated for crotalid @entity5900 over the past 12 years at the Ben Taub General Hospital, Houston. Bites were inflicted by copperheads (56%), water moccasins (15%), and rattlesnakes (12%). In 17% of @entity1 the species of snake was not identified. Using a grading scale of one to four from minimal to severe @entity5900 , 54% were grade I, 29% grade II, 7% grade III, 6% grade IV, and 4% were not graded because the @entity1 were seen more than 12 hours after @entity5900 and not evaluated by other physicians. Five @entity1 received one dose (10 cc) of crotalid antivenin each before transfer to our Emergency Center. All @entity1 were treated with intravenous fluids, antibiotics, @entity116 prophylaxis, immobilization of the injured part, and elevation of the extremity to the level of the heart. No patients received antivenin or excisional therapy at this institution and one @entity2048 was performed. There were no deaths or amputations in this series. Eight @entity1 developed superficial @entity39 of the skin but only one required a skin graft. Three @entity1 developed @entity1503 and were treated with either platelet transfusions or fresh-frozen plasma. One @entity1 required @entity935 for @entity551 refractory to fluid resuscitation. This experience supports a conservative @entity5900 and raises the question about the need to utilize traditional therapy for snakebites caused by species seen in our locality.
