For more than a decade, faculty and residents from UCSF Fresno have partnered with the Fresno Chaffee Zoo’s Reptile House staff to help ensure the safety of employees who work with venomous reptiles from around the world.
The collaboration reflects UCSF Fresno’s commitment to the San Joaquin Valley and supporting partnerships throughout the region, including the zoo’s herpetology team.
“These are medically important snakes and as a toxicologist and an emergency doctor, they invited me to help plan their first aid protocols and teach their team about the medical aspect in case someone should accidentally get bitten,” said Rais Vohra, MD, UCSF Professor of Clinical Emergency Medicine.
As Medical Director of the California Poison Control System's Fresno/Madera Division, Dr. Vohra and his team field thousands of calls annually about venomous exposures, giving him a uniquely regional perspective on snakebite epidemiology and management in the state of California. He also serves on the faculty of the UCSF School of Pharmacy, where he helps to train the next generation of pharmacists and clinical toxicologists.
Zoo staff who care for the venomous reptiles, including feeding them and cleaning their habitats are inherently at risk by virtue of their occupation. As a result, comprehensive training and evidence-based emergency response protocols are essential.
“It’s a very important project to ensure that everyone that works with these beautiful, but potentially dangerous animals, stays safe and that they feel confident in their daily activities whenever they're working around these creatures,” said Vohra.
Mark Halverson, animal curator at the Fresno Chaffee Zoo, oversees the reptiles and their caregivers. He says the longstanding partnership with UCSF Fresno provides valuable expertise and peace of mind.
“Not only do we have a world-class health care facility (Community Regional Medical Center) and UCSF Fresno here, the peace of mind that we get from having a toxicologist like Dr. Vohra working with us gives us the assurance that we're on the up and up and we're doing the right thing,” said Halverson.
To ensure staff safety, the zoo maintains a supply of anti-venom from all over the world stocked in a refrigerator. Proper storage, handling, and use of lifesaving medication requires specialized knowledge in emergency medicine, pharmacy, and toxicology. All of which Dr. Vohra is trained to provide.
“Dr. Vohra also helps if we decide to bring in a species that we don't have any antivenom for,” Halverson said. “He consults with us about the appropriate steps to take, and which antivenoms are appropriate for those species.”
The collaboration extends beyond zoo staff training. Emergency Medicine residents, medical students and even local high school students participating in the Summer Biomedical Internship Program have opportunities to learn through the program.
During training sessions held at the zoo, Vohra teaches participants evidence-based approaches to managing venomous snake bites before emergency medical services arrive. Topics include avoiding harmful practices like applying tourniquets or attempting to suck venom from the wound. Instead, focusing on proven first-aid measures that improve patient outcomes is important.
His expertise in medical toxicology also helps prepare them to recognize and respond to envenomation from a variety of exotic species housed at the zoo, including the cobra, gaboon viper, and several species of Asian vipers.
“We provide education about all of those different species. They require a little bit different approach for each different type of snake, but we're ready to handle any of them and we just want people to stay safe,” Vohra said.
Every six to 12 months, Vohra and UCSF Fresno Emergency Medicine residents conduct refresher training sessions that equip zoo staff with the skills needed to respond immediately after a snake bite.
Rather than waiting for emergency responders to arrive, staff are trained to initiate critical first aid measures. This includes marking the bite location, wrapping the limb, and helping the injured person remain calm and still while awaiting further medical care.
Halverson emphasized that having that training in place from the very beginning helps set the victim up for the best possible outcome. According to him, the partnership has helped establish one of the nation’s most comprehensive venomous animal management programs.
“We have no doubt that what we do is probably the highest caliber here in the U.S. as far as managing the venomous programs here at the zoo, and it's all thanks to Dr. Vohra and his team working with us closely to develop those practices,” said Halverson.
