Moderate-to-severe


Journal

Clinical toxicology (Philadelphia, Pa.)
ISSN: 1556-9519
Titre abrégé: Clin Toxicol (Phila)
Pays: England
ID NLM: 101241654

Informations de publication

Date de publication:
Nov 2021
Historique:
pubmed: 16 3 2021
medline: 9 11 2021
entrez: 15 3 2021
Statut: ppublish

Résumé

Bites by the European adder ( A prospective audit of ViperaTAb use was conducted from March 2016 until November 2020 by the UK National Poison Information Service (NPIS). Users of the NPIS online toxicology database, TOXBASE, considering the use of antivenom for One hundred and seventy patients were administered ViperaTAb antivenom over five years. One hundred and thirty-two were adults and 38 children (median age and range: 38, 2-87 years). Bites occurred across the UK, but most commonly in coastal regions of Wales and of South-West and East England. Median time to presentation was 2.1 (IQR 1.5-4.0) h and to antivenom administration from presentation was 2.0 (IQR 0.9-3.6) h. A minority of patients presented to hospital more than 12 h after being bitten ( ViperaTAb antivenom appears to be effective and safe and should be administered as soon as possible for patients meeting clinical criteria. Patients require close observation following antivenom to detect adverse reactions and progression or recurrence of envenoming. Close collaboration with expert NPIS consultant advice can help optimise antivenom timing, ensure repeated dosing is given appropriately, and avoid unnecessary surgical intervention. All hospitals, particularly those located in areas of relatively high incidence, should stock sufficient antivenom available at short notice, 24 h a day.

Sections du résumé

BACKGROUND BACKGROUND
Bites by the European adder (
METHODS METHODS
A prospective audit of ViperaTAb use was conducted from March 2016 until November 2020 by the UK National Poison Information Service (NPIS). Users of the NPIS online toxicology database, TOXBASE, considering the use of antivenom for
RESULTS RESULTS
One hundred and seventy patients were administered ViperaTAb antivenom over five years. One hundred and thirty-two were adults and 38 children (median age and range: 38, 2-87 years). Bites occurred across the UK, but most commonly in coastal regions of Wales and of South-West and East England. Median time to presentation was 2.1 (IQR 1.5-4.0) h and to antivenom administration from presentation was 2.0 (IQR 0.9-3.6) h. A minority of patients presented to hospital more than 12 h after being bitten (
CONCLUSION CONCLUSIONS
ViperaTAb antivenom appears to be effective and safe and should be administered as soon as possible for patients meeting clinical criteria. Patients require close observation following antivenom to detect adverse reactions and progression or recurrence of envenoming. Close collaboration with expert NPIS consultant advice can help optimise antivenom timing, ensure repeated dosing is given appropriately, and avoid unnecessary surgical intervention. All hospitals, particularly those located in areas of relatively high incidence, should stock sufficient antivenom available at short notice, 24 h a day.

Identifiants

pubmed: 33720783
doi: 10.1080/15563650.2021.1891245
doi:

Substances chimiques

Antivenins 0
Immunoglobulin Fab Fragments 0
Viper Venoms 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

992-1001

Auteurs

Thomas Lamb (T)

National Poisons Information Service - Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK.
Myanmar Oxford Clinical Research Unit, University of Oxford, Oxford, UK.
Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.

David Stewart (D)

National Poisons Information Service - Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK.

David A Warrell (DA)

Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.

David G Lalloo (DG)

Liverpool School of Tropical Medicine, Liverpool, UK.

Pardeep Jagpal (P)

National Poisons Information Service - Birmingham, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.

Dacia Jones (D)

National Poisons Information Service - Newcastle, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.

Ruben Thanacoody (R)

National Poisons Information Service - Newcastle, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.

Laurence A Gray (LA)

National Poisons Information Service - Cardiff, University Hospital Llandough, Cardiff, UK.

Michael Eddleston (M)

National Poisons Information Service - Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK.
Department of Pharmacology, Toxicology, Therapeutics, University/BHF Centre for Cardiovascular Sciences, University of Edinburgh, Edinburgh, UK.

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Classifications MeSH