Everyone at UAB seems to be connecting the dots lately when it comes to snake bites. Dr. Rushton recounted, “At our children’s hospital, pediatric burn dressings are used to reduce pain, and the burn nurses came to me and said, ‘Could we use these dressings to reduce snakebite pain?’ That’s worked amazing[ly] well and helped us reduce pediatric opiate use.” It’s not only the burn nurses who’ve gotten in on the game. “Our physical therapists have written order sets to get people up and moving around quickly,” Dr. Rushton noted. His team also includes ED pharmacists who help coordinate antivenin treatment. “This is very much a multidisciplinary project,” said Dr. Rushton.

These days, Alabamians with bites no longer struggle to find follow-up care. UAB’s center offers it not only to those they see bedside, but also to anyone who calls the state’s Poison Information Center. “It’s a resource for the entire state,” Dr. Rushton reported. “This year we took two people from Georgia too,” he said. Moreover, now that primary care doctors can rely on the UAB center to guide them through follow-up treatment, they’re more willing to take on snakebite patients—and Dr. Rushton and Dr. Shapshak are proud they have empowered their non-emergency medicine colleagues.

Emergency physician Sean Bush, MD, president of the North American Society of Toxinology, applauds UAB’s work. “Follow-up care is a challenge,” said Dr. Bush, an envenomation expert, “Snakebite is an uncommon emergency in most places, so it’s helpful to have people and places with a lot of knowledge and experience managing difficult cases.”

UAB’s new model may inspire colleagues in other states where venomous snakebites are common to start centers of their own—in the Southeast and Southwest especially. “The positive response to the center at UAB—people come to the clinic who are so appreciative of the care—shows that there is a need,” said Anne-Michelle Ruha, chair of the Department of Medical Toxicology at Banner-University Medical Center in Phoenix. “Alabama is setting a good example that others can follow.” Dr. Bush agreed: “Other states and academic medical centers where snakebites are common could definitely benefit from UAB’s approach.”

UAB is also contributing to the academic conversation. In 2021, they published an article looking at novel ways to screen for coagulopathy.² They’re collecting data on how patients heal, particularly with regard to persistent wounds. And in March, Drs. Rushton and Shapshak published a letter in The New England Journal of Medicine stating, “Our experience suggests that management [for snakebites] should embrace a multifaceted approach that includes post-hospitalization therapies targeted to the treatment of persistent venom effects.”