Biomedical subjects
Publications and source records attributed to B Furbee.
Each year over 100,000 exposures to toxic plants are reported to poison control centers around the country. This article focuses on the more toxic plant exposures which may result in critical care admissions. The various plants are identified and described. Their mechanism of toxicity, clinical presentation of exposure and a management strategy for the critical care physician are discussed. Resources for further information are also listed.
Over 5000 Americans suffer from snake bites annually, and of these, nearly one quarter are from poisonous species. Although these cases are undeniably reported, death appears to occur in only a few cases each year, and often reflects delay in obtaining medical care. Two families of venomous snake indigenous to the United States account for most envenomations: Crotalidae (pit vipers or new world vipers) and Elapidae. This article focuses on the snakes of the Crotalidae family.
Many sources advocate the empiric use of antibiotics to prevent wound infection (WI) following crotalid (rattlesnake) envenomations. We undertook a prospective observational study to examine the incidence of infections following crotalid envenomation. We studied crotalid envenomations presenting to our institution with follow-up by direct examination or telephone consultation. All patients presenting to our institution from June 1990 to October 1991 with history and clinical evidence of crotalid envenomation were included in the analysis. Routine management of crotalid envenomation was undertaken in each case, including the use of antivenin, surgical debridement, and antibiotics only when indicated by signs and symptoms of infection. A total of 54 patients were observed during the study period. Twelve patients received prophylactic antibiotics begun either prior to transfer to our institution or following a surgical procedure, and were evaluated separately. Follow-up was obtained on 32 patients 7 or more days following envenomation. Only 1 patient from the study group developed clinical evidence of WI during the study period. We conclude that because of a low incidence of WI in this series, the routine use of prophylactic antibiotics in such patients may not be warranted.