After obtaining IRB approval, the medical records of all patients < 18 years of age presenting to Texas Children’s Hospital (TCH) with a snake bite injury from 1/2006 to 6/2012 were reviewed. Texas Children’s Hospital is a tertiary care, level 1 trauma center in Houston,Texas with over 80,000 emergency department visits annually. Patients coded with an injury mechanism of snake bite were identified through a prospectively collected trauma database. Data collected included the age at presentation, the setting of the injury, the type of snake involved, physical exam findings, and the hospital course. Snake bites were defined as “envenomated” if there was
evidence of edema, discoloration of the site, necrosis, or systemic symptoms. The severity of injury was scored using a novel scale based only on the initial physical examination (Table 1). Patients with systemic symptoms such as neuralgia, paresthesias, paralysis, altered
mental status and/or hypotension received automatic scores of 4,independent of local findings.