Exotic Envenomation in the United States
Venomous snakes not native to the USA exist in zoos, aquariums, serpentariums, academic, public and quasi-public institutions, and private collections, which may or may not be legal, may or may not be known to healthcare providers in their region, and for which there may or may not be preparations for an envenomation. Envenomations by nonnative species pose challenges to every element of the healthcare system. A variety of response systems have been developed in the USA and other countries. A preexisting response system can optimize patient outcomes and lessen stresses on health delivery systems. The specifics of an optimal systematic nonnative envenomation response program will differ by geographic region and healthcare system considerations but should address common issues encountered in these cases regarding provider unfamiliarity, antivenom acquisition and expert consultation. In the USA, a system of antivenom availability through zoos, strategic antivenom geographic placement, information resources through the Antivenom Index and regional poison centers, as well as a national expert consultant panel constitute the current response system.
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