“clinical study on snake bite syndrome, species correlation and asv dose requirement” dr. ann...
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“Clinical study on snake bite syndrome, species correlation and ASV dose requirement”
Dr. Ann MiriamMakunda Christian Leprosy and general Hospital
Bazaricherra P.O,Karimganj Dist.,Assam – 788727
GPS coordinates:24*25'55.78"N92*19'51.33"E
Location
GPS coordinates:24*25'55.78"N92*19'51.33"E
Brief Hospital Statistics 2011-12
Total OP: 91,242Total IP: 9471
Brief statistics of Karimganj DistrictPopulation: 12 Lakhs
Deaths due to snake bites : 0*Oujha : 2
*According to NRHM data
LOWAIRPOA BLOCKPopulation : 1 Lakh
Bazaricherra Gram panchayatPopulation : 12 thousand
A survey was done and it was noticed that there were only 2 deaths by snake bites in the last 15
years.
Common Poisonous snakes in Makunda
Red-necked keelbackRhabdophis subminiatus
Banded kraitBungarus fasciatus
Other venomous snakes identified by the local people
• White lipped pit-viper• Greater black Krait• Monocled Cobra
Oujha
Probable cause of CellulitisTreatment by Oujha – Cutting of snake bitten area by using a blade and applying local herbal medicine
Snake bites last year = 10Venomous bites = 1
Non – venomous bites = 9Mainly Hemotoxic = 1
Dead snakes brought – Nil
OUTCOMES
Patients requiring mechanical ventilation – NilPatients requiring hemodialysis – Nil
Deaths - Nil
FACILITIES AVAILABLE
Bleeding timeClotting time
Whole blood transfusionHemodialysis facilities – Machine available (Not in use)
Mechanical ventilators – yesHigh Dependency area
Blood investigations doneHemogram
Serum CreatinineBlood Sugar
BT / CTPlatelet count
ECG
INDICATION FOR ASV ADMINISTRATION
Prolonged BT/ CTAdrenaline given when there is sign of anaphylaxis
Initial dose of ASV 8 – 10 vialsDuration of administration 4 – 6 hoursTest used for monitoring response -
Whole Blood Clotting TimeTime of measurement of coagulation parameters –
3 times in a day
ADMINISTRATION OF REPEAT DOSE OF ASV
Not given so far
ADMINISTRATION OF CONTINUOUS LOW DOSE OF ASV
Not given so far
CEILING DOSE
No experience
USE OF NEOSTIGMINE
No experience
INDICATION FOR ANTIBIOTIC THERAPY
Cellulitis
COMMON ANTIBIOTICS USED
Ampicillin and Ampicloxacillin
PATIENTS ADMITTED IN
High Dependency area
PATIENTS REFERRED FOR
No referrals so far
COMPANY OF ASV PURCHASE
Haffkine
STOCK OF ASV
10 Vials
Why are snake bites so un-common in Makunda?• Thickly populated location• Venomous snakes present• Dense forests• Frequent floods
THANK YOU