SnakeBite911 Status

Coagulopathy: In clinical trials, recurrent coagulopathy (the return of a coagulation abnormality after it has been successfully treated with antivenin), characterized by decreased fibrinogen, decreased platelets, and elevated prothrombin time, occurred in approximately half of the patients studied; one patient required re-hospitalization and additional antivenin administration.  Do not administer CroFab® to patients with a known hypersensitivity to any of its components, or to papaya or papain unless the benefits outweigh the risks and appropriate management for anaphylactic reactions is readily available.  Two patients had a severe allergic reaction (severe hives and a severe rash and pruritus) following treatment and one patient discontinued CroFab® due to an allergic reaction.  The new this app app comes from the manufacturers of CroFab® CrotalidaePolyvalent Immune Fab (Ovine), a sheep-derived antivenin indicated for the management of adult and pediatric patients with North American crotalid envenomation.  Follow-up all patients for signs and symptoms of delayed allergic reactions or serum sickness (e. g. , rash, fever, myalgia, arthralgia).  Patients allergic to papain, chymopapain, other papaya extracts, or the pineapple enzyme bromelain may also have an allergic reaction to CroFab®.  Adverse reactions involving the skin and appendages (primarily rash, urticaria, and pruritus) were reported in 12 of the 42 patients.  In case of acute hypersensitivity reactions, including anaphylaxis and anaphylactoid reactions, discontinue infusion and institute appropriate emergency treatment.  The most common adverse reactions (incidence ≥ 5% of subjects) reported in the clinical studies were urticaria, rash, nausea, pruritus and back pain.  This useful guide can help educate you about North American venomous pit viper snakes (including rattlesnakes, copperheads and cottonmouths), how to best avoid them, and what to do and what NOT to do should a snake strike happen!  Hypersensitivity Reactions: Severe hypersensitivity reactions may occur with CroFab®.  The term crotalid is used to describe the Crotalinae subfamily (formerly known as Crotalidae) of venomous snakes which includes rattlesnakes, copperheads and cottonmouths/water moccasins.  Patients who experience coagulopathy due to snakebite should be monitored for recurrent coagulopathy for up to 1 week or longer.  Recurrent coagulopathy due to envenomation and requiring additional treatment may occur.  During this period, the physician should carefully assess the need for re-treatment with CroFab® and use of any type of anticoagulant or anti-platelet drug.  Recurrent coagulopathy may persist for 1 to 2 weeks or more.