INCIDENCE OF RETAINED FOREIGN BODY FOLLOWING A SNAKE BITE Dabrowski KH, Rushton WF, Vakkalanka JP, King JD, Charlton NP University of Virginia, Division of Medical Toxicology - Department of Emergency Medicine
Background Results
• Snake bites are a common complaint of ED visitors. • In 2011, there were 6,630 snake bite cases reported to the 1,679 charts • 1,679 charts coded for a snake bite returned American Association of Poison Control Centers.1 indicating a snake from the query. bite • Review of the literature demonstrates only a few cases of a retained • 11% (n=183) contained one of the snake tooth or fang following a snake bite.2,3 aforementioned key terms.
• However, numerous reputable sources for health care providers • Review of these charts did not result in any continue to advocate for routine imaging: cases with a retained foreign body. • [Rule out] retained fangs/teeth in wounds (examine wounds closely; x-ray)4 • 1st tests to order: wound x-ray. Other tests to consider: CT/MRI5 183 cases (11%) Conclusion • Radiographs of the bitten area are needed to exclude contained at least fracture or foreign body in [certain exotic snake bites]6 one key search term • Snake bites are a common presenting problem in U.S. emergency departments.
Methods • Our review found no instances of retained • A single poison center database serving a population of approximately foreign body in snake bites occurring between three million was queried for all cases indicating a snake bite from 2003 and June 2013. January 2003 through June 2013. 0 cases of retained • Based on the data from this poison center, we • Results were then searched for the following key terms: ‘fang’, ‘tooth’, foreign body propose that snake bites do not require routine ‘teeth’, ‘x-ray’, ‘xray’, ‘xr’, and ‘x ray.’ confirmed imaging studies to evaluate for retained foreign bodies as this is an exceedingly rare • Each chart that had at least one key term was independently reviewed occurrence. for the presence or absence of a foreign body. References
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