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Misidentification of copperhead and cottonmouth snakes following snakebites.
Clin Toxicol (Phila). 2018 12; 56(12):1195-1199.CT

Abstract

INTRODUCTION

Copperhead (Agkistrodon contortrix) and cottonmouth or water moccasin (Agkistrodon piscivorus) snakes account for the majority of venomous snakebites in the southern United States. Cottonmouth snakes are generally considered to have more potent venom. Copperheads are considered less venomous and there is some controversy as to whether or not bites from copperhead snakes need to be treated with antivenom. Copperhead and juvenile cottonmouth snakes are both brown in color. The purpose of this study was to evaluate the accuracy of identification by the public and healthcare providers between these two species.

METHODS

Snakebite victims sometimes bring dead snakes to the hospital or have taken pictures of the snake. When this occurred, ED personnel were asked to take a picture of the snake, and forward the picture to the state poison control center. The identification of the snake by witnesses and/or hospital personnel was compared to the identification by the state herpetologist.

RESULTS

During the study period, there were 286 cases of snakebites reported to the state poison control center. Pictures were obtained on 49 of the responsible snakes. All copperhead snakes were identified correctly by callers. However, only 21% of cottonmouth snakes were identified correctly, with 74% of cottonmouth snakes being identified as copperheads. Both public and medical personnel performed poorly on identification of cottonmouth snakes.

CONCLUSIONS

Forty percent of the snakes identified as copperheads were actually cottonmouth snakes. Juvenile cottonmouth snakes were often identified as copperhead snakes.

Authors+Show Affiliations

a Department of Emergency Medicine , Mississippi Poison Control Center, University of Mississippi Medical Center , Jackson , MS , USA.b Mississippi Poison Control Center, University of Mississippi Medical Center , Jackson , MS , USA.c Mississippi State University School of Veterinary Medicine , Starkville , MS , USA.d Department of Emergency Medicine , University of Mississippi Medical Center , Jackson , MS , USA.d Department of Emergency Medicine , University of Mississippi Medical Center , Jackson , MS , USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29792342

Citation

Cox, Robert D., et al. "Misidentification of Copperhead and Cottonmouth Snakes Following Snakebites." Clinical Toxicology (Philadelphia, Pa.), vol. 56, no. 12, 2018, pp. 1195-1199.
Cox RD, Parker CS, Cox ECE, et al. Misidentification of copperhead and cottonmouth snakes following snakebites. Clin Toxicol (Phila). 2018;56(12):1195-1199.
Cox, R. D., Parker, C. S., Cox, E. C. E., Marlin, M. B., & Galli, R. L. (2018). Misidentification of copperhead and cottonmouth snakes following snakebites. Clinical Toxicology (Philadelphia, Pa.), 56(12), 1195-1199. https://doi.org/10.1080/15563650.2018.1473583
Cox RD, et al. Misidentification of Copperhead and Cottonmouth Snakes Following Snakebites. Clin Toxicol (Phila). 2018;56(12):1195-1199. PubMed PMID: 29792342.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Misidentification of copperhead and cottonmouth snakes following snakebites. AU - Cox,Robert D, AU - Parker,Christina S, AU - Cox,Erin C E, AU - Marlin,Michael B, AU - Galli,Robert L, Y1 - 2018/05/24/ PY - 2018/5/25/pubmed PY - 2019/9/14/medline PY - 2018/5/25/entrez KW - Agkistrodon contortrix KW - Agkistrodon piscivorous KW - Snakebite KW - copperhead snake KW - cottonmouth snake SP - 1195 EP - 1199 JF - Clinical toxicology (Philadelphia, Pa.) JO - Clin Toxicol (Phila) VL - 56 IS - 12 N2 - INTRODUCTION: Copperhead (Agkistrodon contortrix) and cottonmouth or water moccasin (Agkistrodon piscivorus) snakes account for the majority of venomous snakebites in the southern United States. Cottonmouth snakes are generally considered to have more potent venom. Copperheads are considered less venomous and there is some controversy as to whether or not bites from copperhead snakes need to be treated with antivenom. Copperhead and juvenile cottonmouth snakes are both brown in color. The purpose of this study was to evaluate the accuracy of identification by the public and healthcare providers between these two species. METHODS: Snakebite victims sometimes bring dead snakes to the hospital or have taken pictures of the snake. When this occurred, ED personnel were asked to take a picture of the snake, and forward the picture to the state poison control center. The identification of the snake by witnesses and/or hospital personnel was compared to the identification by the state herpetologist. RESULTS: During the study period, there were 286 cases of snakebites reported to the state poison control center. Pictures were obtained on 49 of the responsible snakes. All copperhead snakes were identified correctly by callers. However, only 21% of cottonmouth snakes were identified correctly, with 74% of cottonmouth snakes being identified as copperheads. Both public and medical personnel performed poorly on identification of cottonmouth snakes. CONCLUSIONS: Forty percent of the snakes identified as copperheads were actually cottonmouth snakes. Juvenile cottonmouth snakes were often identified as copperhead snakes. SN - 1556-9519 UR - https://www.unboundmedicine.com/medline/citation/29792342/Misidentification_of_copperhead_and_cottonmouth_snakes_following_snakebites_ L2 - http://www.tandfonline.com/doi/full/10.1080/15563650.2018.1473583 DB - PRIME DP - Unbound Medicine ER -