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The ToxIC North American Snakebite Registry


Snakebite affects thousands of people in the United States each year, and is responsible for significant morbidity and even mortality in some victims. Despite the large impact snakebite has on affected individuals, it is a relatively uncommon diagnosis, and many physicians have never treated a patient with snakebite. Medical toxicologists are unique among physician specialists in that they receive specialized training in the management of snakebite.

Current understanding of the pathophysiology of snake venom, factors that may influence morbidity and mortality after snakebite, and ideal management of patients suffering from snake envenomation is incomplete. Much of what is known derives from retrospective case series describing cohorts of patients with envenomation as well as case reports of unusual presentations following snakebite. Published clinical trials of rattlesnake antivenom have provided some prospective information regarding clinical effects of venom and response to treatment with antivenom, but also highlight current limitations in our ability to effectively treat patients and predict outcomes following snake envenomation.

The purpose of ACMT’s ToxIC North American Snakebite Registry is to gather de-identified, detailed prospective information regarding snakebite, clinical effects of envenomation, and response to treatment for patients who receive bedside care from medical toxicologists across the United States. The ultimate goal is to use the information gathered in the Registry to decrease morbidity and mortality resulting from snakebite through enhanced understanding of factors that affect both clinical response to snake envenomation and response to various treatment modalities.

Authorship Guidelines for the North American Snakebite Registry

All medical toxicologists who contribute cases to the registry may be listed as members of the ToxIC Snakebite Study (TICSS) group, which will be credited in all publications stemming from the registry. Individuals with significant administrative involvement in the development and maintenance of the registry will also be considered part of the TICSS group and are eligible for individual authorship.

Individually listed authors will include 1-2 investigators from the site contributing the most cases to the registry, as well as a single investigator from the next two sites with the highest case contribution.

The lead author for any given publication will be a site investigator who has contributed at least five snakebite cases to the registry and who has submitted and received approval for a research proposal to the ACMT Research Committee.

All authors must meet the following requirements: 1) substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; 2) drafting the article or revising it critically for important intellectual content; and 3) final approval of the version to be published.

Principal Investigator Contact Information

Anne-Michelle Ruha, MD

Banner Good Samaritan Medical Center


Download and review the snakebite registry form (PDF version)

To preview the ToxIC snakebite registry click here