Effectiveness of A Clinical Protocol Implemented To Standardize Snakebite Management In Iran: Initial Evaluation

Monzavi, S. M. and Salarian, A. A. and Khoshdel, A. R. and Dadpour, B. and Afshari, R. (2015) Effectiveness of A Clinical Protocol Implemented To Standardize Snakebite Management In Iran: Initial Evaluation. Wilderness and Environmental Medicine, 26 (2). pp. 115-123.

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Abstract

Objective This study was designed to evaluate the effectiveness of a new protocol implemented to standardize snakebite management in Iran. Methods In this study, 27 patients treated according to the new protocol in 2012 (P+) were compared with 22 patients treated according to the previous modality in the year before implementation of the protocol (P-) in Mashhad Medical Toxicology Centre (MTC). Demographic characteristics and treatment details of all patients were recorded prospectively. Envenomation severity of each victim was assessed according to snakebite severity score (SSS). Results After implementation of the protocol, a smaller percentage of patients received antivenom (AV) therapy (78 vs 95; P =.079). In spite of no significant difference in baseline severity of envenomation between the 2 groups (SSS mean ± SD, 34.8 ± 18.1 vs 35.5 ± 17.4; P =.801), the P+ group received significantly fewer AV vials (8.4 ± 6.8 vs 12.1 ± 5.6 vials; P =.042) and had a significantly shorter length of hospital stay (2.2 ± 1.5 vs 3.2 ± 1.8 days; P =.027). Moreover, smaller proportion of P+ patients experienced recurrence of venom-induced effects; however, the difference was not significant (18.5% vs 36%; P =.159). The reduction in use of antiallergy treatments to prevent or treat acute hypersensitivity reactions approached statistical significance (41% vs 68%; P =.051). These findings denote a reduction in AV use of approximately 4 vials and a reduction in hospital stay of 1 day for each patient, which translates to approximately $196/patient in healthcare cost savings. Conclusions Implementation of a snakebite management protocol at MTC reduced overall antivenom usage, use of antiallergy interventions, and length of hospital stay.

Item Type: Article
Additional Information: Cited By :2 Export Date: 16 February 2020 CODEN: WEMEF Correspondence Address: Afshari, R.; Department of Internal Medicine, Imam Reza Hospital, Mashhad University of Medical SciencesIran
Uncontrolled Keywords: clinical protocols comparative effectiveness research Iran Key words antivenoms snakebite venom antiserum algorithm animal human practice guideline Snake Bites Algorithms Animals Antivenins Humans Practice Guidelines as Topic
Subjects: QV pharmacology
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib5 lib5
Date Deposited: 05 May 2020 05:25
Last Modified: 05 May 2020 05:25
URI: http://eprints.mums.ac.ir/id/eprint/18986

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