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Old 08-14-2013, 10:54 AM
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The bite of the Copperhead is rarely fatal.

There are very few deaths from snake bite annually in the US.

Most treatment protocals include supportive therapy such as oxygen, VS monitoring, rest, etc. The bite hurts like heck and the patient wish may they were dead, but they most often times live to fight another day.
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Old 08-14-2013, 10:59 AM
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Originally Posted by Alim Nassor View Post
Just wanted to relay my experience. Thursday evening I went outside to move my water sprinkler. I always go outside barefoot, I like the feel of the grass on my feet. We live north of DFW in the red dirt and rocky area near Gainesville.

Anyways, the temperature has been in the 100's. It was about 8:15 PM and I guess the snake had just come out to cool off in the water. I never saw him until after the bite. I felt something move under my foot and then felt the strike. I immediately thought I had brushed up against a bull nettle. When I looked down I saw the snake crawling away. It was a good sized one and extremely bright. I had found a shed skin just the other day and gave it to my grandson. Probably this snakes from the size of it.

The pain was immediate. My wife drove me to the nearest ER. On our way there I called ahead to see if they had antivenin. They did. They watched me for a couple of hours, gave me morphine, dilaudid and atavan for the pain, but no antivenin and sent me home. I told them I didn't feel right, but they sent me home anyway.

The next morning the pain was intense, I couldn't put any weight on my foot and the swelling was greater. We headed for a different ER, on the way there I started to get nauseated.

As soon as they triaged me, they moved me to ICU and started IV's of CRO-Fab antivenin, Morphine and antibiotics. I was ICU for 2 nights and then moved to a regular room for more observation, more antivenin, more antibiotics and pain meds. The first day in ICU the swelling moved from just above my ankle, to just above my knee. It's still painful.

This morning, the swelling had subsided a bit and I could put weight on it without severe pain. My foot is blue and green. I convinced them to let me go home. I'm glad to be home and as soon as I'm 100% I'll be clearing my place of any venomous snakes I can find. I cringe at the thought of one of my 3 to 5 year old grandkids being the one who stepped on it.

I like snakes, even poisonous ones, but can't take a chance with my grandkids.
Glad you are okay despite the first ER's efforts. If you are looking to remove the snakes, sounds like you should call in the Turtle Man.
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Old 08-14-2013, 07:21 PM
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To the OP: I am retired from the practice of emergency medicine. I spent 25 years in the ER. what those guys in the first ER did was unconscionable. The delay in proper care was significant, and you had some injury and worsening of your condition due to their mistreatment. I suggest you consult a quality injury lawyer. Talk to your local Bar Association, and tell them up front, you want to avoid a Ambulance-Chaser. They will refer you appropriately. If you do 't like the guy, go to another, It doesn't cost you anything for your first consult, and most injury attorneys will take the case on contingency basis. Take care and listen to your provider. Don't balk and don't cut off therapy too soon.
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Old 08-14-2013, 10:48 PM
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Default my 2 cents

I was one of the first Paramedics in Texas to get licensed instead of registered. This means I had to get a Degree. Only a small percentage made it that first year. We were trained in many advanced procedures until the state decided to start National Registry and Dumb us back down. While overseas the military allowed me to perform procedures that would defiantly not be allowed state side. My military service has left me disabled It took me almost a year to learn to walk normal again. I don't like ambulance chasers either. A couple of years ago I had a Shouting match with a Veterans Administration Doctor that was trying to BS me on a diagnosis. After I showed him peer reviewed Studies that proved him wrong he got real nasty. He said he and the VA don't recognize those studies. I asked him what state(s) he held medical licenses in. He said it didn't matter because he worked for the government and could practice anywhere in the county for the VA also because of the Ferris doctrine I couldn't sue him. Yes but I still can file a malpractice complaint against his license to have it revoked. The Doctor actually told me to F off and stormed out of the exam room. I do not believe that 2 hour in a ER for a snake bite meets the GOLD STANDARD of care. You don't have to sue for money to get justice.To sum it up if a Doctor screws up, you as a patient have a right to file a complaint against this Doctor License. He may just get a slap on the wrist or the licensing board may force him to get remedial training / Continuing education. Your actions may save another patients life.

P.S.. I won the fight with the VA.
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Old 08-16-2013, 02:07 PM
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I was one of the first Paramedics in Texas to get licensed instead of registered. This means I had to get a Degree. Only a small percentage made it that first year. We were trained in many advanced procedures until the state decided to start National Registry and Dumb us back down. While overseas the military allowed me to perform procedures that would defiantly not be allowed state side. My military service has left me disabled It took me almost a year to learn to walk normal again. I don't like ambulance chasers either. A couple of years ago I had a Shouting match with a Veterans Administration Doctor that was trying to BS me on a diagnosis. After I showed him peer reviewed Studies that proved him wrong he got real nasty. He said he and the VA don't recognize those studies. I asked him what state(s) he held medical licenses in. He said it didn't matter because he worked for the government and could practice anywhere in the county for the VA also because of the Ferris doctrine I couldn't sue him. Yes but I still can file a malpractice complaint against his license to have it revoked. The Doctor actually told me to F off and stormed out of the exam room. I do not believe that 2 hour in a ER for a snake bite meets the GOLD STANDARD of care. You don't have to sue for money to get justice.To sum it up if a Doctor screws up, you as a patient have a right to file a complaint against this Doctor License. He may just get a slap on the wrist or the licensing board may force him to get remedial training / Continuing education. Your actions may save another patients life.

P.S.. I won the fight with the VA.
Thank for your service and our sincere wishes that you get the best care, treatment and respect for the rest of your days.
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Old 08-17-2013, 05:49 AM
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Thanks for sharing your experience and glad to hear you are doing better. But I was a little disappointed, without a picture...
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Old 08-17-2013, 10:53 AM
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Close call, glad you're getting better.
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Old 08-17-2013, 10:10 PM
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Glad you are okay.

I got bit on the finger when I was younger and dumber (tried to move the copperhead off the trail with a stick). I went home (10 mins away) and my Mom didn't believe me because all I had was a tiny prick mark from one fang on my finger. After asking me repeatedly if I was SURE it was a copperhead she asked me to take her to where the snake was. It wasn't there. On the way back home (30+ minutes after being struck) my hand started throbbing. My now frantic mother decided to drive me to the Navy Hospital ER 45 minutes away. By the time we arrived my hand looked like a latex glove blown full of air. 10 days in the ICU.

Now that I am the parent I know to call 911 immediately.
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Old 08-17-2013, 10:14 PM
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OMG!! You are so lucky to be alive!!
Old 08-18-2013, 06:10 AM
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OMG!! You are so lucky to be alive!!
no not really
Old 08-19-2013, 07:51 AM
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To the OP: I am retired from the practice of emergency medicine. I spent 25 years in the ER. what those guys in the first ER did was unconscionable. The delay in proper care was significant, and you had some injury and worsening of your condition due to their mistreatment. I suggest you consult a quality injury lawyer. Talk to your local Bar Association, and tell them up front, you want to avoid a Ambulance-Chaser. They will refer you appropriately. If you do 't like the guy, go to another, It doesn't cost you anything for your first consult, and most injury attorneys will take the case on contingency basis. Take care and listen to your provider. Don't balk and don't cut off therapy too soon.
I'll second that. Get your medical records. The big questions are what were your blood levels? Platelets, PT, hemoglobin, etc? Did they do any scan of your leg at all? Did they even run the tests? Standard treatment for copperheads isn't really antivenin, though it helps in severe cases. What happens is that the venom triggers your blood to clot causing potential clogs in your veins and arteries, then since all the platelets are used up, the reverse happens and you start bleeding uncontrollably. When our patients come in with a wet bite they get heparin to break up the clots before it gives them a stroke or cuts off circulation to the limb and causes them to lose it, and then platelet infusions to keep you from bleeding out your eyeballs. You then get monitored for 2-3 days to ensure no infection, bleeds, or clots before you can be cleared to go home. No one here shows up with a copperhead bite with affected PT and doesn't get admitted.

What's more is that when they gave you high grade narcotics they acknowledged they thought it was a wet bite and you were seriously invnomated, but they failed to treat you with any accepted treatment for such.

For god's sake don't let that attending keep his license. Even a minor bite can cause you to throw a clot to your brain and kill you with no warning and should have earned you a 24 hour observation stay.
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Old 08-19-2013, 08:05 AM
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just cause someone is a DR or a nurse does not mean they know jack **** about a certain topic with around 8,000 snake bites a year in the US and by 2010 med census there are 850,085 medical doctors in the US thats one bite for every 106.25 doctors or .94%
I know a lot of folks who have gotten tagged and went to the ER and had to tell them what to do because they had 0 experience with envenomations and im not talking about something benign like a copperhead either
We had 4 snake bites this year so far. 2 copperheads, 1 rattlesnake, and 1 black mamba (the man is on his 8th bite so far and keep the antivenin in his fridge). All 4 needed antivenin. Last year it was 4 copperheads. 2 needed antivenin. All but the mamba got heparin. Is that enough?
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Old 08-19-2013, 08:42 AM
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Here, at least they monitor a snake bite victim and classify the bite, as Alim Nassor said.

They do tell you to schedule appointments with a doctor. Doctors clean the dead tissue away, provide for pain relief and antibiotics as well as monitoring the health of the patient.

They do NOT give anti-venom ad hoc. It can create other problems and is used only in life threatening cases.

Take care, Alim Nassor. I knew a couple that put a new trailer in a subdivision that had just been bull dozed to emlarge it. He was bitten twice by copper heads and his wife was bitten three times. All of these bites were on his porch or right around the stairs to it right after dark. They were not life threatening bites and they received proper care for the wounds. These critters seem to be concentrated in large numbers in places like that cleared subdivision.

I respect poisonous snakes as you do. But I also cannot have them on my property for safety reasons. I've not yet managed to calm myself to catch and release. I am morbidly scared of them. I do respect them as a vital part of nature, though.
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Old 08-19-2013, 06:56 PM
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We had 4 snake bites this year so far. 2 copperheads, 1 rattlesnake, and 1 black mamba (the man is on his 8th bite so far and keep the antivenin in his fridge). All 4 needed antivenin. Last year it was 4 copperheads. 2 needed antivenin. All but the mamba got heparin. Is that enough?
why would you administer a blood thinner for a neurotoxin? that to me makes no sense at all now if you said it was a viper of some kind due to the hemotoxic and potentially coagulant effects i could understand but a straight neurotoxin? why?
Old 08-19-2013, 08:51 PM
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I'll second that. Get your medical records. The big questions are what were your blood levels? Platelets, PT, hemoglobin, etc? Did they do any scan of your leg at all? Did they even run the tests?


The first ER did nothing other than pain killers. My foot was swelled like a balloon. No tests, no scan, 2 hours later we were headed home even though I told them I didn't feel right.

Standard treatment for copperheads isn't really antivenin, though it helps in severe cases. What happens is that the venom triggers your blood to clot causing potential clogs in your veins and arteries, then since all the platelets are used up, the reverse happens and you start bleeding uncontrollably. When our patients come in with a wet bite they get heparin to break up the clots before it gives them a stroke or cuts off circulation to the limb and causes them to lose it, and then platelet infusions to keep you from bleeding out your eyeballs. You then get monitored for 2-3 days to ensure no infection, bleeds, or clots before you can be cleared to go home. No one here shows up with a copperhead bite with affected PT and doesn't get admitted.

The second hospital, the next day, took one look at my leg and put me into ICU. They were very worried about 'compartment syndrome" due to the swelling. They did blood work immediately and each day I was there. I was given injections of blood thinner in the stomach twice. They also did an x ray of my foot and ankle. I was also given IV antibiotics. After 3 days/2 nights in ICU I was put in a regular room and released the next day. I still have quite a bit of pain in my foot, but the swelling is about 80% gone.

What's more is that when they gave you high grade narcotics they acknowledged they thought it was a wet bite and you were seriously invnomated, but they failed to treat you with any accepted treatment for such.

I had never had dilauded before, it helped more than the morphine, but it was still very painful. They gave me Atavan about 20 minutes later and the pain finally eased.

For god's sake don't let that attending keep his license. Even a minor bite can cause you to throw a clot to your brain and kill you with no warning and should have earned you a 24 hour observation stay.
We are still discussing it. Thanks for the advice.
Old 08-19-2013, 09:47 PM
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I read an article last week where a woman in the northeast was bitten by a copper head and wound up owing $54,000 for the antivenom. The antivenom was $18,000 per dose.

The likely reason for not getting antivenom at the first ER is that over 60% of bites do not actually inject venom. Antivenom is getting rather scarce in the US and they do not want to use it unless they know you were actually injected with venom and not just bitten.

The article that I read also mentioned a woman stung by a scorpion last year that got a bill for $89,000 for her antivenom treatment.

I think if I ever get bit I may make a quick trip to Mexico for treatment... lol
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Old 08-19-2013, 10:00 PM
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I read an article last week where a woman in the northeast was bitten by a copper head and wound up owing $54,000 for the antivenom. The antivenom was $18,000 per dose.

The likely reason for not getting antivenom at the first ER is that over 60% of bites do not actually inject venom. Antivenom is getting rather scarce in the US and they do not want to use it unless they know you were actually injected with venom and not just bitten.

The article that I read also mentioned a woman stung by a scorpion last year that got a bill for $89,000 for her antivenom treatment.

I think if I ever get bit I may make a quick trip to Mexico for treatment... lol
man stuff for scorpions/spider are ridiculously expensive like 600+ a gram and thats for the poison not antivenom or anything like that just due to the low low yield per creature

venom for most snake venom is relatively cheap compared
http://www.kyreptilezoo.org/?Venom_E...nom_Price_List if your a researcher these guys do good work and i recommend them the species of the topic tho you will have a hard time getting due to its demand at the moment

antivenin like crofab is actually only 750-800 a vial the other several grand per dose is all mark up
Old 08-20-2013, 09:27 AM
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why would you administer a blood thinner for a neurotoxin? that to me makes no sense at all now if you said it was a viper of some kind due to the hemotoxic and potentially coagulant effects i could understand but a straight neurotoxin? why?

"All but the mamba"

All we did was get the antivenin in him, put him on oxygen, vanc, park him in the icu ready to vent if needed, and then provide comfort. It's getting obnoxiously routine. Some handlers rely way too much on the idea that if they get bit they'll just go to the hospital and nothing could go wrong.
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Old 08-20-2013, 12:00 PM
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"All but the mamba"

All we did was get the antivenin in him, put him on oxygen, vanc, park him in the icu ready to vent if needed, and then provide comfort. It's getting obnoxiously routine. Some handlers rely way too much on the idea that if they get bit they'll just go to the hospital and nothing could go wrong.
thanks for re iterating the all but part sometimes i scramble things when i read esp when tired
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