Emergency Medicine Wed 21 July 2021 A clinical study of snake bite patients presenting to emergency department
Researcher : Guruparan r
Research Guide : Vinayaswamy pm
Institution Name : Jjm medical college


Background & objective: In India snake bite often occurs as an occupational hazard among the agrarian population living in suburban and rural areas. A recent study estimates that atleast 4, 21,000 envenoming and 20,000 deaths occur worldwide from snakebite each year. A delay in diagnosis and treatment causes fatality. This study was conducted to study (i) the clinical presentation of snake bite patients (ii) the prognostic significance of ASV administration from time of bite till 1st dose of ASV (iii) the complications and overall outcome of snake bite patients. Materials and methods: The data was collected from 70 patients admitted to JJM Medical College presenting with history of snake bite for a period of 2 years (September 2016 – September 2018). Results: Among the 70 patient’s majority were Males (69%) and in the age group of 31 to 40years. Majority of the victims received ASV within 3hrs of bite (31.4%) followed by 3 to 6 hrs (18.6%), more than 9hrs (17.1%), and 6 to 9 hrs (14.3%). Regarding the total ASV administered, minimum was 10vials (20%) and maximum was 40 vials (7.1%). Most common complication observed was vasculotoxicity (32.86%), followed by neurotoxicity (24.29%), local toxicity (8.57%), vasculotoxicity with nephrotoxicity (8.57%), vasculotoxicity with local toxicity (7.14%). Nontoxic snake bites were 18.57%. Regarding the days of hospital stay majority stayed for 3 to 4 days (41.4%) followed by 5 to 6 days (30%) which is mostly observed in patients who received ASV within 3hrs 50% and 31.8% respectively. Longer hospital stay 9-10days and more than 10 days were observed in patients who received ASV after more than 9hrs (33.3%) and between 6 to 9 hrs. Among the 70 victim’s mortality was 11.4% which is mostly observed in patients who received ASV after 9hrs (37.5%) but this is not statistically significant. Conclusion: Delay in ASV administration is associated with increased hospital stay which is statistically significant. The number of ASV required was more in patients who received their 1st dose ASV late. The most common complication observed was vasculotoxicity, followed by neurotoxicity. Mortality was also more in patients who received 1st dose ASV late but not statistically significant. So the key to minimizing mortality and morbidity is early hospitalization with aggressive management of ABC’s of resuscitation, and early administration of ASV.

DOI: 1626861146   Year of publication: 2019

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