Clinical Manifestations, Treatment and Outcomes of Snake bite cases in a Tertiary care hospital- A Record based Retrospective Study
Keywords:
Snake bite; Signs of envenomation; Neurotoxic manifestations; Anti Snake Venom (ASV); Non-poisonous snakesAbstract
Introduction: Snake bite is an important occupational hazard in India. Systematic documentation of site of bite, time of bite, treatment used, duration of hospital stay and outcome will help in contributing towards optimization and efficient utilization of resources, training of emergency staff handling of snake bites, planning resource allocation, procurement of medicines. The objectives of the study were to determine the proportion of snake bites with clinical features of envenomation, to document the clinical signs of envenomation and the medications used in snake bite with regard to dose and duration and outcomes including duration of stay, complications, need for additional interventions and death. Methods: Data was extracted by a retrospective observational study of case records from the department of General Medicine in our college, from January 2011 to November 2020 after obtaining approval from ethics committee. Results: In this study, data was extracted from 28 snake bite case records, in which two cases were non-poisonous snake bites, four cases did not have any signs of envenomation and 22 snake bite cases presented with signs of envenomation of which 14 snake bite cases received Anti Snake Venom (ASV) in an average dose of 8.35 vials per person as mentioned in the case records. Cellulitis (57.13%) was the most documented complication and no deaths were documented. Conclusion: According to this study most of the snake bite cases presented with signs of envenomation, of which larger portion had neurotoxic manifestations. No deaths were documented due to early shifting to hospital and effective man agement of the cases.
Downloads
References
Halesha BR, Harshavardhan L, Lokesh AJ, et al. A study on the clinico-epidemiological profile and the outcome of snake bite victims in a tertiary care centre in Southern India. J Clin Diagn Res. 2013;7(1):122-126. doi:10.7860/JCDR/2012/4842.2685.
Kalantri S, Singh A, Joshi R, et al. Clinical predictors of in-hospital mortality in patients with snake bite: A retrospective study from a rural hospital in central India. Trop Med Int Health. 2006;11(1):22-30. doi:10.1111/j.1365-3156.2005.01535.x.
Warrell D. Injuries, envenoming, poisoning, and allergic reactions caused by animals. 2010. doi:10.1093/med/9780199204854.003.0902.
Bhalla G, Mhaskar D, Agarwal A. A study of clinical profile of snake bite at a tertiary care centre. Toxicol Int. 2014;21(2):203-208. doi:10.4103/0971-6580.139811.
Chandrakumar A, Suriyaprakash TNK, et al. Evaluation of demographic and clinical profile of snakebite casualties presented at a tertiary care hospital in Kerala. Clin Epidemiol Glob Health. 2016;4(3):140-145. doi:10.1016/j.cegh.2015.12.003.
Mathews M, Balakrishnan S. Study of clinical and epidemiological profile of poisonous snake bite in a tertiary centre in North Kerala. Int J Res Med Sci. 2019;7(11):4059-4063. doi:10.18203/2320-6012.ijrms20194588.
Gupta R, Gupta BM, Gupta A. Drug usage in the management of snake bite patients in a tertiary care teaching hospital - A retrospective study. Int J Med Sci Public Health. 2018;7(12):954-958. doi:10.5455/ijmsph.2018.0722311082018.
Suraweera W, Warrell D, et al. Trends in snakebite deaths in India from 2000 to 2019 in a nationally representative mortality study. Elife. 2020;9:1-37. doi:10.7554/eLife.54076.
Thapar R, Darshan BB, et al. Clinico-epidemiological profile of snakebite cases admitted in a tertiary care centre in South India: A 5 years study. Toxicol Int. 2015;22(1):66-70. doi:10.4103/0971-6580.172260.
Williams D, Gutiérrez JM, et al. The Global Snake Bite Initiative: an antidote for snake bite. Lancet. 2010;375(9708):89-91. doi:10.1016/S0140-6736(09)61159-4.

