Annals of Emergency Medicine
Volume 45, Issue 6 , Pages 603-608 , June 2005

Pressure-Immobilization Bandages Delay Toxicity in a Porcine Model of Eastern Coral Snake (Micrurus fulvius fulvius) Envenomation

  • Benjamin T. German, MD
  • ,
  • Jason B. Hack, MD
  • ,
  • Kori Brewer, PhD
  • ,
  • William J. Meggs, MD, PhD

      Affiliations

    • Corresponding Author InformationAddress for correspondence: William J. Meggs, MD, PhD, Division of Toxicology, Department of Emergency Medicine, Brody School of Medicine at East Carolina University, 600 Moye Boulevard, Greenville, NC 27858; 252-744-2954, fax 252-744-3589

Received 9 July 2004 ,Revised 8 November 2004 ,Accepted 29 November 2004.

References 

  1. Watson WA, Litovitz TL, Klein-Schwartz W, et al. 2003 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 2003;22:335–404
  2. Litovitz TL, Klein-Schwartz W, Rodgers GC, et al. 2001 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 2002;20:391–452
  3. Litovitz TL, Klein-Schwartz W, White S, et al. 2000 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 2001;19:337–395
  4. Litovitz TL, Klein-Schwartz W, White S, et al. 1999 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 2000;18:517–574
  5. Litovitz TL, Klein-Schwartz W, Caravati EM, et al. 1998 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 1999;17:435–487
  6. Litovitz TL, Klein-Schwartz W, Dyer KS, et al. 1997 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 1998;16:443–497
  7. Litovitz TL, Smilkstein M, Felberg L, et al. 1996 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 1997;15:447–500
  8. Litovitz TL, Felberg L, White S, et al. 1995 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 1996;14:487–537
  9. Litovitz TL, Felberg L, Soloway RA, et al. 1994 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 1995;13:551–597
  10. Litovitz TL, Clark LR, Soloway RA. 1993 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 1994;12:546–584
  11. Litovitz TL, Holm KC, Clancy C, et al. 1992 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 1993;11:494–555
  12. Litovitz TL, Holm KC, Bailey KM, et al. 1991 Annual report of the American Association of Poison Control Centers National Data Collection System. Am J Emerg Med. 1992;10:452–505
  13. Litovitz TL, Bailey KM, Schmitz BF, et al. 1990 Annual report of the American Association of Poison Control Centers National Data Collection System. Am J Emerg Med. 1991;9:461–509
  14. Litovitz TL, Schmitz BF, Bailey KM. 1989 Annual report of the American Association of Poison Control Centers National Data Collection System. Am J Emerg Med. 1990;8:394–442
  15. Litovitz TL, Schmitz BF, Holm KC. 1988 Annual report of the American Association of Poison Control Centers National Data Collection System. Am J Emerg Med. 1989;7:495–545
  16. Litovitz TL, Schmitz BF, Matyunas N, et al. 1987 Annual report of the American Association of Poison Control Centers National Data Collection System. Am J Emerg Med. 1988;6:479–515
  17. Litovitz TL, Martin TG, Schmitz B. 1986 Annual report of the American Association of Poison Control Centers National Data Collection System. Am J Emerg Med. 1987;5:405–445
  18. Litovitz TL, Normann SA, Veltri JC. 1985 Annual report of the American Association of Poison Control Centers National Data Collection System. Am J Emerg Med. 1986;4:427–458
  19. Litovitz T, Veltri JC. 1984 Annual report of the American Association of Poison Control Centers National Data Collection System. Am J Emerg Med. 1985;3:423–450
  20. Veltri JC, Litovitz TL. 1983 Annual report of the American Association of Poison Control Centers National Data Collection System. Am J Emerg Med. 1984;2:420–443
  21. Parrish HM, Khan MS. Bites by coral snakes: report of 11 representative cases. Am J Med Sci. 1967;253:561–568
  22. Russell FE. Snake Venom Poisoning. New York, NY: Scholium; 1983;1-562
  23. White J. Overview of venomous snakes of the world. In:  Dart RC editors. Medical Toxicology. Philadelphia, PA: Lippincott Williams & Wilkins; 2004;p. 1543–1559
  24. ESI Lederle (Wyeth-Ayherst) product discontinuation notice. Philadelphia, PA: January 30, 2001.
  25. Sutherland SK, Coulter AR, Harris RD. Rationalisation of first aid measures for elapid snakebite. Lancet. 1979;1:183–186
  26. Anker RL, Straffon WG, Loiselle DS, et al. Snakebite: comparison of three methods designed to delay uptake of “mock venom.”. Aust Fam Physician. 1983;12:365–368
  27. Howarth DM, Southee AE, Whyte IM. Lymphatic flow rates and first aid in simulated peripheral snake or spider envenomation. Med J Aust. 1994;161:695–700
  28. Tun-Pe , Muang-Muang-Thwin , Myint-Myint-Than , et al. The efficacy of compression immobilization technique in retarding spread of radiolabeled Russell's viper venom in Rhesus monkeys and “mock venom” NaI131 in human volunteers. Southeast Asian J Trop Med Public Health. 1994;25:349–353
  29. Tun-Pe , Aye-Aye-Myint , Khun-Ei-Han , et al. Local compression pads as a first-aid measure for victims of bites by Russell's viper (Daboia russelii siamensis) in Myanmar. Trans R Soc Trop Med Hyg. 1995;89:293–295
  30. Pe T, Mya S, Myint AA, et al. Field trial of efficacy of local compression immobilization first-aid technique in Russell's viper (Daboia russelii siamensis) bite patients. Southeast Asian J Trop Med Public Health. 2000;31:346–348
  31. Davidson TM, Eisner J. United States coral snakes. Wildn Environ Med. 1996;1:38–45
  32. Norris RL. Snake envenomations, coral [eMedicine.com Web site]. Available at: http://www.emedicine.com/emerg/topic542.htm. Accessed May 11, 2004.
  33. White J. Elapid snakes. In:  Dart RC editors. Medical Toxicology. Philadelphia, PA: Lippincott Williams & Wilkins; 2004;p. 1566–1578
  34. Norris RL, Bush SP. North American venomous reptile bites. In:  Auerbach PS editors. Wilderness Medicine. St. Louis, MO: Mosby; 2001;p. 896–926
  35. Tibballs J, Kuruppu S, Hodgson WC, et al. Cardiovascular, haematological and neurological effects of the venom of the Papua New Guinean small-eyed snake (Micropechis ikaheka) and their neutralisation with CSL polyvalent and black snake antivenoms. Toxicon. 2003;42:647–655
  36. Tanen DA, Danish DC, Clark RF. Crotalidae polyvalent immune Fab antivenom limits the decrease in perfusion pressure of the anterior leg compartment in a porcine crotaline envenomation model. Ann Emerg Med. 2003;4:384–390
  37. Green SM, Cardwell MD, Hayes WK. Effects of a negative pressure venom extraction device (Extractor) on local tissue injury after artificial rattlesnake envenomation in a porcine model. Wilderness Environ Med. 2000;11:180–188
  38. Bania TC, Bernstein SL, Baron BJ, et al. Intraarterial vs intravenous administration of antivenin for the treatment of Crotalidae atrox envenomation: a pilot study. Acad Emerg Med. 1998;5:894–898
  39. Norris RL, Dart RC. Apparent coral snake envenomation in a patient without visible fang marks. Am J Emerg Med. 1989;7:402–405
  40. Norris RL, Minton SA. Non-North American venomous reptile bites. In:  Auerbach PS editors. Wilderness Medicine. St. Louis, MO: Mosby; 2001;p. 927–995
  41. Fix JD, Minton SA. Venom extraction and yields from the North American coral snake, Micrurus fulvius. Toxicon. 1976;14:143–145
  42. Gaar GG, Normann SA. Coral snakes. In:  Ford MD editors. Clinical Toxicology. Philadelphia, PA: WB Saunders Company; 2001;p. 873–877

 Author contributions: BTG, KB, JBH, and WJM were involved in the design of the study, working in the laboratory, and preparation of the manuscript. BTG, WJM, and KB were involved in ordering materials. KB was involved in the statistical analysis. WJM takes responsibility for the paper as a whole.Funding and support: This study was funded by the Emergency Medicine Residents Research Fund at the Brody School of Medicine Medical Foundation.Reprints not available from the authors.

PII: S0196-0644(04)01741-X

doi: 10.1016/j.annemergmed.2004.11.025

Annals of Emergency Medicine
Volume 45, Issue 6 , Pages 603-608 , June 2005