Biology Reference
In-Depth Information
Comments
As detailed in Section 4.5, although the victim/author attempted to provide a case
account, the report is typically flawed due to a lack of formal medical review, subjec-
tivity, and incorrect misinterpretation of factors influencing the outcome of the bite as
well as the described symptoms/signs. It is noted that several features of the case
are similar to some that have been formally reported (see Section 4.2; Weinstein &
Keyler, 2009). Regardless, the case cannot be acceptably analyzed as it lacks the
minimal standard of any appropriate clinical case report (Section 4.5). Evidence-
based analyses of clinical cases must be held at an acceptable standard, whether
the case involves a colubroid snakebite, myocardial infarction, diverticulitis, and so
on. For instance, it is not possible to confidently analyze a case of haematuria posted
on the Internet. Such a case requires formal medical history, examination, investi-
gation, and documentation. The nature of any presentation must not change, lower,
or in any way alter the standard expected in formal reporting of a clinical case.
The identity of the snake in this case is not in question, as the victim posted pho-
tos of the specimen biting his finger. This should not encourage similar experimen-
tation as the effects can, on occasion, be significant. Clearly, the victim allowed the
snake to remain engaged on his finger in order to observe the effects of a protracted
bite (Section 4.5). The victim's previous exposures, bites, and possible medical
comorbidities are unknown. Obviously, at the least, the victim has had regular expo-
sure to this snake for the period of ownership of the specimen (reportedly 8 years).
In the USA, the medical history and, if applicable, documented details regarding pre-
vious snakebite incidents are personal medical data protected by Health Insurance
Portability and Accountability Act (HIPAA) 2 statutes, and these constitute another
reason (medicolegal) for the low evidence value of such cases posted on the Internet.
Case 2. Jackson's Black Tree Snake, Thrasops jacksoni
Websites
http://forums.kingsnake.com/view.php?id 1510152,1510152
http://www.reptileforums.co.uk/snake-pictures/124251-thrasops-jacksoni.html
Features of Case
Described by the victim/author (presumably male, age unknown), this case involved
a bite inflicted by an approximately 48-inch captive T. jacksoni . Photos of the snake
2 The HIPAA of 1996 provides security and privacy rules that establish US national standards for the pro-
tection of individually identifiable health information and security of electronically stored personal medical
records. The implications of this Act also accentuate the need for competent medical evaluation and profes-
sional reporting of any clinical presentation, including medically significant snakebites. Such information
publically posted on the Internet can be subject to misuse, whether purposely or unintentionally. See http://
www.hhs.gov/ocr/privacy/ for further information regarding the medico-legal issues related to this Act.
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