Assessing the effect of a medical toxicologist in the care of rattlesnake envenomated patients

Abstract

Rattlesnake envenomation is an important problem in the United States, and the management of these envenomations can be complex. Despite these complexities, however, the majority of such cases are managed without the involvement of a medical toxicologist. The primary objective of this study is to evaluate the impact of a medical toxicology service on the length of stay of such patients. Methods: The authors conducted a retrospective study at six centers in California and Arizona. Patients were included if they were admitted in the two years before the establishment of a medical toxicology service (pre-MTS) or in the two years after the creation of a medical toxicology service (post-MTS). Results: A total of 300 subjects were included (169 pre-MTS; 131 post MTS). Baseline characteristics between the pre-MTS and post-MTS group were very similar. The creation of a medical toxicology service was associated with a significant reduction in the length of stay (69.5 [59.1-79.9] vs. 48.1 [41.4-54.8] hours). This reduced length of stay was not associated with any statistically significant change in readmission rates. Conclusion: Rattlesnake bite patients treated by a medical toxicologist have a significant reduced length of stay compared to those without direct involvement of a medical toxicologist.

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