Snake bite management pdf

Apply first aid if you cannot get the person to the hospital right away. Snake bite is an occupational disease of farmers, plantation workers, herdsmen, fishermen, snake restaurant workers and other food producers. Identification of the species of snake responsible for the bite is important for optimal clinical management. Many emergency rooms stock antivenom drugs, which may help you.

If a person has been bitten by a poisonous snake, antivenin may be used to counteract the toxins. With early diagnosis and proper management, including administration of the appropriate dose of antisnake venom asv and adjuvant treatment with. I have seen a lot of bad advice regarding snakebite management in this and other groups, and id like to set the record straight. Cover the bite with a clean, loosefitting, dry bandage. Snakes may have found quiet shelter at your workplace whilst the site has been vacant over weekends or holiday breaks. In addition the panelrecognizedthatnotreatment algorithm could.

Prevent or respond to snake bitenatural disasters and. First aid and prehospital management of venomous snakebites. These are the recommendations for prehospital treatment. There are large number of conflicting protocolsfor dealing with first aid and treatment. Guideline snake bite who 2016 perhimpunan dokter ahli. The incidence of snakebite mortality is particularly high in southeast asia. 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.

Assess abcs abcs and initiate appropriate resuscitation efforts. The local management of the snakebite site is a matter of some controversy. Viper bites in man are much more common than elapid bites, except in australasia, where vipers do not occur naturally. Once airway, breathing and circulation have been assessed and stabilised, the diagnosis can be made and specific management undertaken. Up to 50% of all venomous bites are reported to be dry bites, i.

If the snake is known to be venomous andor there are symptoms of poisoning, antivenom. 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. 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. Factors not contributing to outcome are size of the snake and time of bite daynight 2.

Incidence of snake bite in india there is a huge gap between the number of snakebite deaths reported from direct survey and official data. Pdf management of snakebite an update researchgate. Much of the first aid currently carried out is ineffective and dangerous simpson, 2006. A high incidence of snake bite envenomation has been reported from marathwada, maharashtra. Commence documentation on the snake bite clinical pathway see appendix 1.

As in previous releases this utilises minimal colour and may be printed easily from the pdf version in the electronic compilation. The attendingphysician shouldassesthebites, shape and number of pods which are identificationmarks. The victim may receive all, a portion, or none of the venom when the snake strikes. Inspect the area of the biteinspect the area of the bite, looking for fang marks, which may appear to. Knowing the size, color and shape of the snake can help determine the best treatment for a particular bite. 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.

It is therefore a medical problem that has important implications for. These guidelines are a revised and updated version of similar guidelines published by the who regional office in southeast asia in 1999. 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. Feb 18, 2015 about 54 types of venomous snakes are found in india about 15000 to 20000 deaths are reported every year in india.

Pakistan has an estimated 20,000 snakebite deaths each year. Anyone whose occupation requires time outdoors has a chance of. To conduct a training course for master trainers and test their teaching skills by. Ultimately, pit viper rattlesnakes, copperheads, cottonmouthswater moccasins envenomations are diagnosed clinically. Rational use of snake antivenom can substantially reduce mortality and morbidity due to snake bites. This publication aims to pass on a digest of available knowledge about all clinical aspects of snakebite to medically trained personnel. The emergency care clinical network has updated this statewide guidance on managing snake bite envenomation or suspected snake bite.

Snakebite and spiderbite clinical management guidelines 20. 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. 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. 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. Management of poisonous snakebites american college of.

Prevent or respond to snake bitenatural disasters and severe. Snakebite and spiderbite management guidelines, south. Treatment early access to medical care in a health facility that has personnel trained and capable of diagnosing snakebite envenoming is essential. Management of venomous snake bites in north america. Rational use of snake antivenom can substantially reduce mortality and morbidity due to snakebites. When you return to your home, be cautious of snakes that may have sought shelter in your home. Provided by the centers for disease control and prevention cdc. 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. Management of snake bite the clinical establishments. 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.

Snakebite first aid fangs that are grooved to allow the venom to flow down the fang surface and trickle into the wound. Management of snake bite in general pain snakebite can often cause severe pain at the bite site. A venomous snake can inject venom into subcutaneous tissues, muscle. Overview of snakebite toxicology veterinary manual. Conservative estimates put the deaths related to snakebite in between 35,000 50,000 per year in india alone. Snakes can continue to bite and inject venom with successive bites until they run out of venom. With coral snake bites, there may be little evidence of local reaction at the bite site.

Australian venom research unit, faculty of medicine, dentistry and health sciences, university of melbourne, parkville, vic, 3010. Elapids are generally restricted to southern edges of the usa, whereas crotalids are dispersed across the continent. This study analysed the pattern of snakebites and their management in a rural area of india over a 10. Diagnosis of the species of snake responsible for the bite is important for optimal clinical management. Fishermen are still occasionally bitten by sea snakes but rarely reach hospitals alive. 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. A dry bite is when the snake strikes but no venom is released. Clinical management of snakebite in papua new guinea. Anyone whose occupation requires time outdoors has a chance of encountering a snake, particularly in warmer states in the south, southwest and west.

Unified treatment algorithm for the management of crotaline. An estimated 7,000 to 8,000 venomous snake bites occur annually in the. Venom concentration and constitution depends on environmental conditions as well as snakes maturity and darkness of colour of snake bawaskar hs et al 2014. Tetanus and rabies status only for mammalian bites must be addressed. A common sign of a bite from a venomous snake is the presence of two puncture wounds from the animals fangs.

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. Handling tourniquets care must be taken when removing tight tourniquets which most of the time used. 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. All bites and stings from vertebrate organisms should be evaluated by plain radiograph as barbs and teeth are frequently left in patients after attacks. 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. Guidelines for the management of snakebites world health. About 54 types of venomous snakes are found in india about 15000 to 20000 deaths are reported every year in india. This study analysed the pattern of snake bites and their management in a rural area of india over a 10. Its public health importance has been largely ignored by medical science.

It is stressed that this is not a suitable substitute for formal training. Lay or sit the person down with the bite below the level of the heart. 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. 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. Management of venomous snake bites in north america emdocs. 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. Oct 20, 2015 pdf version management of snake bites.

A high incidence of snakebite envenomation has been reported from marathwada, maharashtra. Antivenom is the only effective antidote for snake venom. No need to hurt the snake just because youre angry, and you dont want to incur additional injury. Aug 28, 2008 identification of the species of snake responsible for the bite is important for optimal clinical management. And i want to help prevent any bad outcomes for both humans and snakes if a snakehuman interaction goes awry. Characterization of these and of standard antivenoms should significantly improve the management of snake bite throughout the world. Incidence of snake bite in india there is a huge gap between the number of snakebite deaths reported from. Who guidelines for the management of snakebites, 2nd edition.

There are no quality studies to guide the management of north american coral snake bites. If possible, take these steps while waiting for medical help. All cases of suspected snake bite should be observed for sufficient time to exclude delayed envenoming. The main goal is to administer the correct antivenom as soon as possible.

Management all suspected should be initially managed in a monitored, high dependency bed or snakebites treatment space. 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. Guidelines for the management of snakebite in hospital by. 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. The outcome of all snakebites depends on a multitude of factors. Full text get a printable copy pdf file of the complete article 1. Sudden removal can lead to a massive surge of venom leading to neurological. 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. These included snakebites to the head and neck, snakebites causing rhabdomyolysis, and apparent anaphylactic or anaphylactoid reactions to venom.

Guidelines for the management of snakebite in hospital snakebite is a common medical problem in sri lanka. Initial management includes basic resuscitation and assessment of the patient. Snakebite first aid vanderbilt university medical center. Sri lanka medical association colombo this print edition contains the text of the revised electronic guidelines version 3. 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. Venomous snakes found in the continental united states include rattlesnakes, copperheads. 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.

Management of poisonous snakebites chris cribari, md, facs clinical evaluation of the snakebite victim 1. However, it is expensive and usually in short supply and its use carries the risk of potentially dangerous reactions. Snake bites management and treatment cleveland clinic. This may result in redness, swelling, and severe pain at the area, which may take up to an hour to appear. 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.

Mainclinical features of snake bite percentage effectsofpoisoning approximate average capableof natural timeto snake poisoning local systemic mortality% deathh elapids 50 slowswelling,then neurotoxiceffects. A snakebite is an injury caused by the bite of a snake, especially a venomous snake. This can be treated with painkillers such as paracetamol. Poison is a toxin that kills or injures the bodys tissues and organs through its chemical actions. Information on how to prevent or respond to a snake bite. 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. Up to 50% of all venomous bites are reported to be dry bites. Sedating analgesics should be avoided as they have the potential to exacerbating respiratory depression and depressed mental status. 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. The incidence of snake bite mortality is particularly high in southeast asia. Snake bites education epidemiology prevention and control therapy. This can slow down the spread of venom if the snake is venomous. Dry bites will be painful and may cause swelling and redness around the area of the snake bite.

The initial management includes dealing with airway, breathing and treatment of shock. Snakebite and spiderbite clinical management guidelines. Treatment group,whose role was to develop recommendations toreduce mortality according. Safely and rapidly transport the victim to an emergency medical. 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. Antivenoms are made by immunizing a horse or sheep with the venom of a particular snake, then processing. Most snake species are nonvenomous, have no fangs, and belong to the colubrid family. Snake bite or suspected snake bite is a rare but dangerous condition.