Snake Bite -A review
Journal Title: Journal Of Pediatric Critical Care - Year 2018, Vol 5, Issue 6
Abstract
Snake bite is a common but under-reported medical emergency accounting for 0.5% of all deaths with greater risk of fatal envenomation in children. In India, four species of venomous snake are most common but better classification of medically significant species is warranted. Snake venom is a mixture of peptides with enzymatic & toxic properties which mediate activation of cytokine cascades along with organ specific toxicities, manifesting into local and systemic symptoms. The syndromic approach of attributing a constellation of signs & symptoms to a particular family of venomous snake has clinical acceptance but overlaps exist. Management of snake bite victim starts with a first aid measures of reassurance, immobilization and quick transfer to hospital. Measures such as application of tourniquet, incision and suction are harmful & should not be done. On arrival at hospital, triage and stabilization of Airway, Breathing & Circulation (ABC) is done followed by a focused assessment to ascertain the severity of envenomation. Antivenom treatment is the mainstay of snake bite management. ASV should be started only when specific indications such as signs of neurotoxicity, coagulopathy, hypotension, hematuria are present. Indiscriminate use of ASV is strongly condemned. Currently 8-10 vials of ASV as initial dose with a maximum of 25 vials is recommended. There is no role of test dose of ASV. Measures to treat any ASV induced anaphylaxis should be ready prior to start of ASV treatment. Supportive treatment is as important in determining the final outcome of envenomation as ASV.
Authors and Affiliations
Manish Kumar, Lokesh Tiwari
Keywords
Related Articles
- EP ID EP441428
- DOI 10.21304/2018.0506.00442
- Views 73
- Downloads 0
An Interesting Case of Snake Bite With Necrotizing Fasciitis: A Case Report
Snake bites are associated with various immediate life threatening complications depending upon the type of venom injected. Most of the immediate complications are well taken care of by timely intervention and use of ASV...
A case report of Conjoined Twin(PYGOPAGUS) separation
We report successful separation of PYGOPAGUS twins. Meticulous planning and multidisciplinary approach are the core aspects in the management of Pygopagus conjoined twins. Early elective separation versus delayed separat...
Effectiveness of 7% versus 3% hypertonic saline nebulization in infants with acute bronchiolitis : A randomized controlled trail
Acute bronchiolitis, the most common lower respiratory tract infection,is the leading cause of hospitalization among infants. The objective of the study is to compare the effect of 7% hypertonic saline (HS) with 3% HS am...
Effectiveness Of A Targeted Temperature Management Protocol Using A Cooling Blanket In Critically Ill Children With Acute Brain Injury
.
Pediatric Myxedema Coma – presenting as Surgical Abdomen
Myxedema com, also called myxedema crisis is a rare life threatening clinical condition that represents severe hypothyroidism. It may be the initial presentation in pediatric patients with prolonged untreated hypothyroid...