@article{ref1,
title="Suspected snakebite in children: a study of 156 patients over 10 years",
journal="Medical journal of Australia",
year="1996",
author="Mead, H. J. and Jelinek, G. A.",
volume="164",
number="8",
pages="467-470",
abstract="OBJECTIVE: To describe the epidemiology and clinical features of children presenting to an emergency department with suspected snakebite. DESIGN: A retrospective study of patient records. SETTING: An emergency department of a children's teaching hospital (Princess Margaret Hospital) in Perth, Western Australia. PARTICIPANTS: All children attending the emergency department from 1984 to 1993 with suspected snakebite. MAIN OUTCOME MEASURE: Clinical and laboratory evidence of envenomation. RESULTS: Over the decade studied, 156 children (mean age, six years and eight months) presented with suspected snakebite; over two-thirds (68%) were boys. In at least 31% of cases, no appropriate first aid had been applied. Only 14 children were envenomed according to clinical and laboratory criteria: 10 of these had coagulopathy; one of the 10 also had rhabdomyolysis. A Venom Detection Kit was used in 117 children. The test gave a positive result in 21 children (13%). Antivenom was given to 18 children, 14 of whom were definitely envenomed. Four of the envenomed children returned a negative result of Venom Detection Kit testing at all sites tested, and in five patients not clinically envenomed the urine specimen tested positive with the Venom Detection Kit (presumably a false positive result or subclinical envenomation). Of the 156 children, 130 were admitted to hospital, and 26 were discharged directly from the emergency department. All children recovered completely. CONCLUSIONS: (i) Many children did not receive appropriate first aid for snakebite; (ii) Most children with suspected snakebite presenting to the emergency department were not envenomed; (iii) Envenomation was best diagnosed by clinical features and laboratory investigations, with the Venom Detection Kit being used to determine the appropriate antivenom; (iv) Discharging children directly from the emergency department is not recommended.<p /><p>Language: en</p>",
language="en",
issn="0025-729X",
doi="",
url="http://dx.doi.org/"
}