Snakes are reptilians, which inhabit forests, and dark and cold places. Some are water Snakes ,either plain-water or ses-water,plain-water snakes are almost Non-poisonous and all most all Sea-snakes are poisonous. They come out during the monsoons and during this time the chances of snakebites increase. Rural areas have more rates of snakebites than the urban areas.
Snakes can
be poisonous
or non-poisonous. The poisonous snakes include
1. Cobras
2. Kraits
3. Vipers
4. Sea snakes.
The severity of the bite depends upon the following factors
1. Amount of the venom injected.
2. Whether the bite was through clothing.
3. The angle at which the bite was given
4. The status of the glands of the snakes.
CLINICAL FEATURES
Parents or guardians come forth with history of snake or unknown bite.
The parents or neighbours may bring the killed snake.
The child may have fang marks. There may be local swelling, edema,
redness, pain and purpuric areas with tenderness. The patient may be
anxious and irritable.
There are three types of poisons
Neurotoxic- from cobra bites. The
patient has altered
sensorium, convulsions, ptosis, bulbar palsies, coma, and
respiratory paralysis.Nausea and vomiting is prominant and
diagnostic.
Vasculotoxic- The vipers release toxins
like hemolysins,proteases, hyaluronidases etc., which cause the local swelling and
coagulation defects. There will be bleeding from the body orifices
and petechiae on the skin. Local ecchymotic patches will be seen in
and around the bite area. The child enters into disseminated
intravascular coagulopathy and shock.Bleeding from GIT ,in the
Brain,may lead to death.
Myotoxic- Sea snakes have a myotoxic
action. There is a lot of pain
at the site of the bite and myalgia. The patient may have
myoglobinuria (passage of the myoglobin from the muscles into the
urine) and renal failure due to this may be seen.
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TREATMENT
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First-Aid
1.The
parents of the child with snakebite are very worried about the
outcome. The child if old enough also may be tense. Hence
reassurance should be given to them.
2.The clothing of the
child should be loosened and he must be allowed fresh air
3.Tourniquet may be applied above the site of the bite over a single
bone. It should be loosened in between every 10 minutes for 15-30
secs. The tourniquet should not be tight enough to occlude the
arterial supply but only the lymphatic and venous drainage.
4.Clean the wound
throughly with water.The limb
should be immobilized and kept elevated. Magnesium sulphate
dressings help in early reduction of edema. Ice packs may also be
used.
5,Sucking
of the poison from the wound is controversial and is best
avoided.
6Give the
patient cardio respiratory resuscitation if there is difficulty
in breathing.
Specific-Treatment 1.Anti-snake venum ... :- as soon as the signs of poison is observed ASV is given after test dose. 1 vial of ASV iv given or run a 5% Dex drip mixed with ASV , repeat the dose (2 nd dose) after 2 hrs. if necessary repeat after 5 hrs. some times up to 10,20 0r 30 injections may be needed. 2.Higher anti-biotics are given to prevent infection. corticoids inj. may be,given to prevent shock. ====================================================================================== This site is Prepared / Dr.Seshagirirao,Vandana-MBBS Srikakulam_A.P(India) Send your Medical Problems for Free Advise & Treatment ======================================================================================= |
