Category: Wilderness

Bleeders Bleed, and Snakebites Don’t Help

A guest post by Justin Hensley (@EBMGoneWild) of Evidence-Based Medicine Gone Wild.

As the population ages, and the drug companies convince more and more  people to take drugs, new trends start showing up in medicine. One of them is patients taking antiplatelet and anticoagulant medications having other problems. Certainly there has been trauma literature on patients taking those medications, and now there is a toxicologic study.

In said study, the authors went back into their huge rattlesnake bite database in Arizona to identify those patients who were taking antiplatelet and/or anticoagulant medications. Comically, there were patients who had multiple snakebites, but they were only enrolled for their first bite. Also one patient was taking aspirin, clopidogrel, and warfarin, to go ahead and knock out any chance of hemostasis. They then looked for “early bleeding”, “late bleeding” or bleeding “at any time.” Major bleeding was markedly increased over controls, as was early bleeding and late bleeding. Length of stay and use of antivenom was not significantly different, however.


Take home messages? Antivenom does not correct coagulopathies secondary to medications, and late bleeding is much higher in patients on those medications, so laboratory observation of those patients should be extended. Also, avoid traipsing through rattlesnake country if you’re on blood thinners.
Bleeding Following Rattlesnake Envenomation in Patients With Preenvenomation Use of Antiplatelet or Anticoagulant Medications.

“Bleeding Following Rattlesnake Envenomation in Patients With Preenvenomation Use of Antiplatelet or Anticoagulant Medications.”
http://www.ncbi.nlm.nih.gov/pubmed/24628755

Lunacy, Animal Bites, and You

A guest post by Justin Hensley (@EBMGoneWild) of Evidence-Based Medicine Gone Wild.

The word “lunacy” receives its etymology from the belief the moon can cause disorders of the mind.  Multiple things – including crime, crisis incidence, and human aggression – are all positively correlated with the phases of the moon.  It is obvious that the moon affects human behavior, but does it affect other animals?

From 1 January 1997 to 31 December 1999 there were 1621 patients seen at the Bradford Royal Infirmary ambulatory and emergency department with a diagnosis of “bite”. The overwhelming majority of these bites (95.1%) are from dogs, with the rest from cats, horses, and rats in descending order. To break down the 29.530589 day lunar cycle, the authors divided it into 10 periods, 9 with 3 days, and 1 with 2 days. Using that breakdown they were able to get a statistically significant difference in the incidence of animal bites at or about the full moon. 

What to take from this? Well, we can’t determine causation from this study certainly. Is it still human behavior causing increased bites, or are animals also influenced by lunar cycles? Notwithstanding the confidence intervals for the “high period” covering the entirety of their chart, they don’t break down the data for each day of the lunar cycle. Most human behavior differences in the full moon have to do with increased nocturnal light, and this doesn’t apply during the day. No reasons are given for the seemingly arbitrary divisions of the lunar cycle either.

Perhaps “lunacy” is every bit a misnomer as “hysteria”.

“Do animals bite more during a full moon? Retrospective observational analysis”

Lunacy, Animal Bites, and You

A guest post by Justin Hensley (@EBMGoneWild) of Evidence-Based Medicine Gone Wild.

The word “lunacy” receives its etymology from the belief the moon can cause disorders of the mind.  Multiple things – including crime, crisis incidence, and human aggression – are all positively correlated with the phases of the moon.  It is obvious that the moon affects human behavior, but does it affect other animals?

From 1 January 1997 to 31 December 1999 there were 1621 patients seen at the Bradford Royal Infirmary ambulatory and emergency department with a diagnosis of “bite”. The overwhelming majority of these bites (95.1%) are from dogs, with the rest from cats, horses, and rats in descending order. To break down the 29.530589 day lunar cycle, the authors divided it into 10 periods, 9 with 3 days, and 1 with 2 days. Using that breakdown they were able to get a statistically significant difference in the incidence of animal bites at or about the full moon. 

What to take from this? Well, we can’t determine causation from this study certainly. Is it still human behavior causing increased bites, or are animals also influenced by lunar cycles? Notwithstanding the confidence intervals for the “high period” covering the entirety of their chart, they don’t break down the data for each day of the lunar cycle. Most human behavior differences in the full moon have to do with increased nocturnal light, and this doesn’t apply during the day. No reasons are given for the seemingly arbitrary divisions of the lunar cycle either.

Perhaps “lunacy” is every bit a misnomer as “hysteria”.

“Do animals bite more during a full moon? Retrospective observational analysis”