Snake bite management pdf

Full text get a printable copy pdf file of the complete article 1. These guidelines are a revised and updated version of similar guidelines published by the who regional office in southeast asia in 1999. Snakebite and spiderbite management guidelines, south. To conduct a training course for master trainers and test their teaching skills by. Cover the bite with a clean, loosefitting, dry bandage. Treatment early access to medical care in a health facility that has personnel trained and capable of diagnosing snakebite envenoming is essential. Management all suspected should be initially managed in a monitored, high dependency bed or snakebites treatment space. Identify or be able to describe the snake, but only if it can be done without significant risk for a second bite or a second victim. I have seen a lot of bad advice regarding snakebite management in this and other groups, and id like to set the record straight. This publication aims to pass on a digest of available knowledge about all clinical aspects of snakebite to medically trained personnel. A bite by a north american copperhead on the ankle is usually a moderate injury to a healthy adult, but a bite to a childs abdomen or face by the same snake may be fatal.

Characterization of these and of standard antivenoms should significantly improve the management of snake bite throughout the world. Anyone whose occupation requires time outdoors has a chance of. Many emergency rooms stock antivenom drugs, which may help you. Management of snake bite the clinical establishments. Once airway, breathing and circulation have been assessed and stabilised, the diagnosis can be made and specific management undertaken. Venom concentration and constitution depends on environmental conditions as well as snakes maturity and darkness of colour of snake bawaskar hs et al 2014. Sedating analgesics should be avoided as they have the potential to exacerbating respiratory depression and depressed mental status.

With early diagnosis and proper management, including administration of the appropriate dose of antisnake venom asv and adjuvant treatment with neostigmine, atropine, and ventilation, we have. Sudden removal can lead to a massive surge of venom leading to neurological. Management of snake bite in general pain snakebite can often cause severe pain at the bite site. Anyone whose occupation requires time outdoors has a chance of encountering a snake, particularly in warmer states in the south, southwest and west. There are large number of conflicting protocolsfor dealing with first aid and treatment. Preventing and managing snake bites snakes come out of hibernation during the warmer months and in urban areas will inevitably move into, or near places where people live and work in search of food or a mate. Guidelines for the management of snakebite in hospital snakebite is a common medical problem in sri lanka. A venomous snake can inject venom into subcutaneous tissues, muscle. Identification of the species of snake responsible for the bite is important for optimal clinical management. Handling tourniquets care must be taken when removing tight tourniquets which most of the time used. However, it is expensive and usually in short supply and its use carries the risk of potentially dangerous reactions. First aid and prehospital management of venomous snakebites. Australian venom research unit, faculty of medicine, dentistry and health sciences, university of melbourne, parkville, vic, 3010.

When you return to your home, be cautious of snakes that may have sought shelter in your home. Excision of the bite site was once recommended, but it is now understood that this is a disfiguring procedure that does not confer any survival benefit. Factors not contributing to outcome are size of the snake and time of bite daynight 2. Its public health importance has been largely ignored by medical science. A high incidence of snake bite envenomation has been reported from marathwada, maharashtra. This means, a health centre which is equipped with the basic resources needed to provide immediate emergency treatment needs, including the administration of antivenom and other adjunct therapy. The attendingphysician shouldassesthebites, shape and number of pods which are identificationmarks. This study analysed the pattern of snakebites and their management in a rural area of india over a 10. Much of the first aid currently carried out is ineffective and dangerous simpson, 2006. Since 1976, we have been studying the clinical effects, management, and prevention of envenoming by the big four cobra, krait, russells viper, and echis carinatus in rural maharashtra, india. If possible, take these steps while waiting for medical help. Although surgeons are often involved in the management of snake envenomation in the united states, it is essential to recognize that snakebites are a medical, not surgical, condition.

May 08, 2020 although surgeons are often involved in the management of snake envenomation in the united states, it is essential to recognize that snakebites are a medical, not surgical, condition. Treatment group,whose role was to develop recommendations toreduce mortality according. Inspect the area of the biteinspect the area of the bite, looking for fang marks, which may appear to. Venomous snakes of north america are members of either of two families. Vol 375 january 2, 2010 77 snake bite david a warrell snake bite is a common and frequently devastating environmental and occupational disease, especially in rural areas. All cases of suspected snake bite should be observed for sufficient time to exclude delayed envenoming. Incidence of snake bite in india there is a huge gap between the number of snakebite deaths reported from. No need to hurt the snake just because youre angry, and you dont want to incur additional injury. These are the recommendations for prehospital treatment. The incidence of snakebite mortality is particularly high in southeast asia. Antivenom is the only effective antidote for snake venom.

Clinical management of snakebite in papua new guinea introduction2with so many challenges to overcome, one could be forgiven for thinking that survival after snakebite is a slim possibility, and while the chances of death are certainly higher in png than in australia, the reality is that many people do survive snakebite. Dial 911 or call local emergency medical services ems. Basic first aid for snake bite envenomation objectives the aim of this component is to provide the student with a concise and rational approach to the diagnosis, treatment and patient management of. Snake bite david a warrell snake bite is a common and frequently devastating environmental and occupational disease, especially in rural areas of tropical developing countries.

Inspect the area of the biteinspect the area of the bite, looking for fang marks, which may appear to be a small abrasion or laceration. The initial management includes dealing with airway, breathing and treatment of shock. An estimated 7,000 to 8,000 venomous snake bites occur annually in the. These included snakebites to the head and neck, snakebites causing rhabdomyolysis, and apparent anaphylactic or anaphylactoid reactions to venom. Feb 18, 2015 about 54 types of venomous snakes are found in india about 15000 to 20000 deaths are reported every year in india.

These guidelines are a revised and updated version of similar guidelines published by. Mainclinical features of snake bite percentage effectsofpoisoning approximate average capableof natural timeto snake poisoning local systemic mortality% deathh elapids 50 slowswelling,then neurotoxiceffects. In addition the panelrecognizedthatnotreatment algorithm could. Indian national snakebite protocols first aid treatment protocol of primary importance is the need to recommend the most effective first aid for victims, to enable them to reach the nearest medical facility in the best possible condition. Elapids are generally restricted to southern edges of the usa, whereas crotalids are dispersed across the continent. Snake bites management and treatment cleveland clinic. With early diagnosis and proper management, including administration of the appropriate dose of antisnake venom asv and adjuvant treatment with. Antivenoms are made by immunizing a horse or sheep with the venom of a particular snake, then processing. Information on how to prevent or respond to a snake bite. Incidence of snake bite in india there is a huge gap between the number of snakebite deaths reported from direct survey and official data.

And i want to help prevent any bad outcomes for both humans and snakes if a snakehuman interaction goes awry. Snakebite is an occupational disease of farmers, plantation workers, herdsmen, fishermen, snake restaurant workers and other food producers. Management of venomous snake bites in north america. Knowing the size, color and shape of the snake can help determine the best treatment for a particular bite. This may result in redness, swelling, and severe pain at the area, which may take up to an hour to appear. Snakes may have found quiet shelter at your workplace whilst the site has been vacant over weekends or holiday breaks. Rational use of snake antivenom can substantially reduce mortality and morbidity due to snake bites.

If you or someone else can safely and quickly get a picture of the snake, great, but dont waste time or risk a second envenomation. Dry bites will be painful and may cause swelling and redness around the area of the snake bite. Overview of snakebite toxicology veterinary manual. This can be treated with painkillers such as paracetamol. The main goal is to administer the correct antivenom as soon as possible. Snakebite and spiderbite clinical management guidelines 20. Prevent or respond to snake bitenatural disasters and severe. Snakebite and spiderbite clinical management guidelines. These guidelines are a revised and updated version of regional guidelines for the management of snakebites published by the who regional office in southeast asia in 2011. It is therefore a medical problem that has important implications for. Type of environment must be assessed marine environment can have decompression sickness if deep. Snakebite and spiderbite clinical management guidelines 20 third edition summaryrevised clinical resource document which provides information and advise on the management of patients with actual or suspected snakebite or spiderbite, and the appropriate levels, type and location of stored antivenom in nsw health facilities. A dry bite is when the snake strikes but no venom is released.

These included snakebites to the head and neck, snake bites causing rhabdomyolysis, and apparent anaphylactic or anaphylactoid reactions to venom. Snake bite or suspected snake bite is a rare but dangerous condition. Tetanus and rabies status only for mammalian bites must be addressed. Snakebite first aid fangs that are grooved to allow the venom to flow down the fang surface and trickle into the wound. Because you cant tell if a snakes bite is a dry bite, always assume that you have been injected with venom, and manage the bite as a medical emergency. Guideline snake bite who 2016 perhimpunan dokter ahli. Provided by the centers for disease control and prevention cdc. A snakebite is an injury caused by the bite of a snake, especially a venomous snake. The victim may receive all, a portion, or none of the venom when the snake strikes. If the snake is known to be venomous andor there are symptoms of poisoning, antivenom.

Management of venomous snake bites in north america emdocs. If you know the snake is not venomous, treat as a puncture wound. All bites and stings from vertebrate organisms should be evaluated by plain radiograph as barbs and teeth are frequently left in patients after attacks. Unified treatment algorithm for the management of crotaline. Diagnosis of the species of snake responsible for the bite is important for optimal clinical management. Guidelines for the management of snakebite in hospital by. With coral snake bites, there may be little evidence of local reaction at the bite site. As in previous releases this utilises minimal colour and may be printed easily from the pdf version in the electronic compilation. Viper bites in man are much more common than elapid bites, except in australasia, where vipers do not occur naturally. Assess abcs abcs and initiate appropriate resuscitation efforts. Snake bite is an occupational disease of farmers, plantation workers, herdsmen, fishermen, snake restaurant workers and other food producers.

In an insufficient information scenario, a lack of knowledge regarding signs of envenoming, time of the accidental bite, snake genus, amount of injected venom, site of injection, and patients. To develop and test a standard curriculum and teaching materials for training health staff in snake bite management at the various levels of the health care system. I am confident that these revised guidelines will help member states to improve the management of snakebites in the peripheral health services and thereby reduce the morbidity and mortality due to snakebites. From the field to the hospital reginald g alex, professor, department of emergency medicine, christian medical college, vellore ramya i, professor, department of medicine, christian medical college, vellore mousumi sen, associate professor, department of forensic medicine, christian medical college, vellore anand zachariah, professor and head, department. Safely and rapidly transport the victim to an emergency medical. Commence documentation on the snake bite clinical pathway see appendix 1. It is stressed that this is not a suitable substitute for formal training. Prevent or respond to snake bitenatural disasters and. Because you cant tell if a snakes bite is a dry bite, always assume that you have been injected with venom, and manage the bite as a. If a person has been bitten by a poisonous snake, antivenin may be used to counteract the toxins.

Fishermen are still occasionally bitten by sea snakes but rarely reach hospitals alive. If a venomous snake bites you, call 911 or your local emergency number immediately, especially if the bitten area changes color, begins to swell or is painful. Sri lanka medical association colombo this print edition contains the text of the revised electronic guidelines version 3. A high incidence of snakebite envenomation has been reported from marathwada, maharashtra. After a natural disaster, snakes may have been forced from their natural habitats and move into areas where they would not normally be seen or expected. Snakebite first aid vanderbilt university medical center. About 54 types of venomous snakes are found in india about 15000 to 20000 deaths are reported every year in india. Apply first aid if you cannot get the person to the hospital right away.

The outcome of all snakebites depends on a multitude of factors. Who guidelines for the management of snakebites, 2nd edition. Poison is a toxin that kills or injures the bodys tissues and organs through its chemical actions. Oct 20, 2015 pdf version management of snake bites. Aug 28, 2008 identification of the species of snake responsible for the bite is important for optimal clinical management. Up to 50% of all venomous bites are reported to be dry bites, i. There are no quality studies to guide the management of north american coral snake bites. Pakistan has an estimated 20,000 snakebite deaths each year. Clinical management of snakebite in papua new guinea. Lay or sit the person down with the bite below the level of the heart. Symptoms of a snakebite may not begin until the body goes into shock. Snakes can continue to bite and inject venom with successive bites until they run out of venom. Management of poisonous snakebites chris cribari, md, facs clinical evaluation of the snakebite victim 1.

A common sign of a bite from a venomous snake is the presence of two puncture wounds from the animals fangs. The incidence of snake bite mortality is particularly high in southeast asia. Venomous snakes found in the continental united states include rattlesnakes, copperheads. The local management of the snakebite site is a matter of some controversy. From the field to the hospital reginald g alex, professor, department of emergency medicine, christian medical college, vellore ramya i, professor, department of medicine, christian medical college, vellore mousumi sen, associate professor, department of forensic medicine, christian medical college, vellore anand zachariah, professor and. Up to 50% of all venomous bites are reported to be dry bites.

Conservative estimates put the deaths related to snakebite in between 35,000 50,000 per year in india alone. This study analysed the pattern of snake bites and their management in a rural area of india over a 10. Guidelines for the management of snakebites world health. Pdf management of snakebite an update researchgate. The emergency care clinical network has updated this statewide guidance on managing snake bite envenomation or suspected snake bite. This can slow down the spread of venom if the snake is venomous. Ultimately, pit viper rattlesnakes, copperheads, cottonmouthswater moccasins envenomations are diagnosed clinically.