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<< Bites and Stings – Snakes, Spiders, and Scorpions in the United States

Critical Appraisal Of The Literature

The literature review for this article included Ovid MEDLINE® and PubMed searches for articles related to crotaline and elapid snakebites, black widow and brown recluse spider envenomations, and scorpion stings. Further manual literature searches of references from key publications and textbooks provided additional articles for review. The relevant literature cited in this article is provided for the reader in the reference section.

The major limitation of the literature for all of these envenomations is the lack of randomized, controlled human studies of therapeutic interventions, including the use of antivenom. Much of the literature consists of small animal studies or uncontrolled case series. The literature used for this review article consisted of 37 case reports/series, 22 review articles, 10 retrospective chart reviews, 10 in-vitro comparative studies, 5 prospective studies, 5 letters to the editors, and 2 textbooks. However, the use of published guidelines and grading systems should provide more consistency in the treatment of these envenomations and provide the basis for future study of outcomes for therapeutic interventions.

Although there are no universally accepted standards of care, we seek to provide an evidence-based approach to management while reminding the reader of the limitations of the literature.

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Last Modified: 05/26/2017
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