Anyone else out there having a CroFab shortage? CroFab is the current state of the art in crotalidae envenomations (and that’s my first link to the Toxicology Center of the Republic of Kazakhstan).
I had a patient with a moderately-severe snakebite (probably a copperhead by the description) recently, and had to get way too many people involved to get CroFab for treatment (we got it). We were told there was a ‘nationwide backorder’ by our pharmacy and by the regional poison control center.
I was OK with that until I went to the FDA’s Drug Shortage Page which is silent on the issue of CroFab, indicating there may not be a nationwide shortage.
Who’s right? Tell me if you are having problems, or not. Maybe this has somehow escaped reporting.
Sorry to hear about your antivenom shortage. Here in St. Louis we have the good fortune to be near a world class zoo with many different kinds of antitoxins available.
We once had a snake bite victum last year. I don’t remember the kind of snake other than it was exotic. He was a private collector. We called in the Herpatology dept. at the zoo and not only recieved the antivenom, but it was delivered by the curator,who knew the victom. It seems that snake people stick together.
You had to give antivenin to a copperhead bite? At our hospital we see an average of 20-30 copperhead bites per year, mostly in the spring. In the last 23 years we have not had to give antivenin. This includes the youngest pt of about 4 years old that I saw. Most all of them get a modest amount of swelling and pain. The usual treatment is a tetanus shot, a dose of rocephin, pain meds and observation for a few (up to six) hours for 99%. Occasionly we admit someone overnight for pain control of continued observation. But so far no Crofab. Rattlesnakes and Cottonmouths are a differnt story. We tend to see a high number of snake bites, I think most of them are a result of poor judgement or too much alcohol. I sometimes wonder if we should be more concerned about the wellbeing of the snake after it bites some people.
Hmm,
The copperhead was a guess by another EP as to the odd behavior of the serpent (it stayed in bushes this old lady was trimming, then bit her after she reached in to get something). I know rattlers, that’s all.
And, yes, CroFab. When she came in it was 2 hrs later and she had dense edema 1/2 way up the forearm, and by the time she went upstairs it was 2/3 to her shoulder.