Document Detail


Management of snakebite cases by national treatment protocol at Jalpaiguri District Hospital in West Bengal in the year 2010--a retrospective study.
MedLine Citation:
PMID:  22315862     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Snakebite remains a public health problem in India, occurring most frequently in the summer and rainy seasons. Bites are maximal in lower limbs. Victims are typically male and between 17 and 27 years of age. Children and the elderly have higher mortality. The worst affected states are Kerala, Maharashtra, Tamil Nadu, Orissa, Assam and West Bengal. There was no uniform guideline for treatment of snakebite cases. The five common venomous Indian snakes biting humans are common cobra, krait, Russell's viper, saw scaled viper and the hump nose pit viper. Seventy per cent of all snakebites are non-venomous. Even in bites by venomous snakes, envenomation occurs in only 50% of cases. Immobilisation is much more important than tight ligature, which may cause gangrene. Only a minority need antivenom, which is expensive, short in supply and may cause severe reaction. Antivenom treatment is recommended on the basis of local and systemic signs and symptoms and 20 minutes whole blood clotting test (20WBCT). Delay in starting AVS treatment is the main cause of mortality and morbidity. Skin test is of no value. But antivenom should not be used unless specifically indicated. The "Do it RIGHT" approach of national treatment protocol indicates the initial steps to be taken before reaching a hospital or primary healthcare facility. And it resulted in a 66% decline in the amount of ASV administration and an absolute reduction of mortality by 24%. However first aid treatment of the bitten limb/area with broad-spectrum antibiotics, injection tetanus antitoxin and Supportive treatment with blood transfusion, ventilatory support, anticholinesterase and peritoneal dialysis may also be required.
Authors:
Manab Kumar Ghosh
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Indian Medical Association     Volume:  109     ISSN:  0019-5847     ISO Abbreviation:  J Indian Med Assoc     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2012-02-09     Completed Date:  2012-03-08     Revised Date:  2012-03-15    
Medline Journal Info:
Nlm Unique ID:  7505608     Medline TA:  J Indian Med Assoc     Country:  India    
Other Details:
Languages:  eng     Pagination:  553-4, 559-60     Citation Subset:  IM    
Affiliation:
Department of Tropical Medicine, School of Tropical Medicine, Kolkata 700073.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antivenins / therapeutic use
Child
Female
Humans
Immobilization
Immunologic Factors / therapeutic use
Male
Middle Aged
Retrospective Studies
Snake Bites / diagnosis,  therapy*
Young Adult
Chemical
Reg. No./Substance:
0/Antivenins; 0/Immunologic Factors

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