About 54 types of venomous snakes are found in india about 15000 to 20000 deaths are reported every year in india. Viper and sea snake venoms also cause intravascular haemolysis. Knowing the size, color and shape of the snake can help determine the best treatment for a particular bite. Factors not contributing to outcome are size of the snake and time of bite daynight 2. A snakebite is an injury caused by the bite of a snake, especially a venomous snake. This study analysed the pattern of snake bites and their management in a. Symptoms of a snakebite may not begin until the body goes into shock. 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.
Cover the bite with a clean, loosefitting, dry bandage. Sea snakes, or coral reef snakes, are a subfamily of venomous elapid snakes, the hydrophiinae, that inhabit marine environments for most or all of their lives. Sea snake, any of more than 60 species of highly venomous marine snakes of the cobra family elapidae. Sea and land snakebites in australia are potentially fatal and immediate medical attention should be sou. However, it is expensive and usually in short supply and its use carries the risk of potentially dangerous reactions. It causes rapidly developing swelling of the bitten part. Conservative estimates put the deaths related to snakebite in between. A common sign of a bite from a venomous snake is the presence of two puncture wounds from the animals fangs. The proper study of snake bite toxinology requires an understanding of snake zoology.
However, available asv may have some advantage by cross reaction. Who guidelines for the management of snakebites, 2nd edition. The who regional office for southeast asia had developed and published guidelines for the management of snakebites as a special issue of the south east asian journal of tropical medicine and public health in 1999 followed by publication of the guidelines. Snakebites are wellknown medical emergencies in many parts of the world, especially in rural areas. Sea snakes also have valves in their nostrils that shut water out when they swim.
Classically they cause a descending symmetrical paralysis and myotoxicity. Snake bites are lifethreatening injuries that can require intensive care. Guidelines for the management of snakebites, 2nd ed who. Remove anything tight from around the bitten part of the body e. Identification 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. Clinical management of russells viper bites tinnuswe 46 9. Snakebite first aid fangs that are grooved to allow the venom to flow down the fang surface and trickle into the wound. If a person has been bitten by a poisonous snake, antivenin may be used to counteract the toxins. Following an elapid bite, paralysis is first detectable as ptosis and external ophthalmoplegia appearing as early as 15 minutes after the bite. The most common scenario is a bite from handling, usually when trying to remove them from fishing nets. Forhad uddin hasan chowdhury maruf assistant registrar medicine dhaka medical college hospital 2.
In cases of serious envenomation, an internist or intensivist should be consulted for admission to the hospital or intensive care unit, respectively. Emergency treatment of a snake bite journal of emergencies. In papua new guinea snake bite victims account for 60% of all ventilator beddays in intensive care units. If a sea snake bite or sting or bite of a marine creature is suspected, it is always important to call your local emergency helpline number or dial 911 in the us without any delay, and provide as much information as possible, even if the individual does not have any symptoms. Hydrophiidae and are characterized by vertically flattened tails and nostrils with valvelike flaps. Depending on the type of snake, signs and symptoms of a bite may include. Rare severe bites are by king cobras and sea snakes. However, unlike a predatory strike when hunting, the snake may not release as much or any venom when startled, decreasing risk of serious injury. Incidence of snake bite in india there is a huge gap between the number of snakebite deaths reported from. Animportant finding fromthese andotherepidemiological studies is thatoverhalfthe. While bsks seldom bite humans, the snake that bit the young fisherman was probably stressed and felt threatened after getting ensnared in the trawling net. Some sea snakes still have some of the behaviour and traits of their ancestors, such as laticauda, which can move a little on land. Specific asv for sea snake and pit viper bite is not available in india. Poison is a toxin that kills or injures the bodys tissues and organs through its chemical actions.
However, the two species of beaked sea snakes are aggressive. Introduction snake bite is an important public health hazard in bangladesh estimated. Elapid and sea snake venoms have significant neurotoxicity. At present, 17 genera are described as sea snakes, with 62 species they evolved from snakes that lived on the land. This can be treated with painkillers such as paracetamol. They live in marine environments for most or all of their lives. Sedating analgesics should be avoided as they have the potential to exacerbating respiratory depression and depressed mental status. 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. Management of snake bite national guideline 2014 dr. The three families of venomous front fanged snakes are the elapids, vipers, and sea snakes. Guidelines for the management of snakebites world health. A snake may strike defensively when startled or provoked.
In a series from chandrigah in india, out of 1862 patients with snake bites 3% developed aki. 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. Most are extensively adapted to a fully aquatic life and are unable to move on land, except for the genus laticauda, which has limited land movement. Management of snake bite in general pain snakebite can often cause severe pain at the bite site. Sea snakes, or coral reef snakes, are venomous elapid snakes. Management of poisonous snakebites chris cribari, md, facs clinical evaluation of the snakebite victim 1. A bite from a sea snake does not cause pain initially the site of the bite may show only a small pin prick where the bite occurred without pain. The priorities for treatment of people bitten by snakes. Guidelines for the clinical management of snake bites in. There are no quality studies to guide the management of north american coral snake bites.
Fishermen are still occasionally bitten by sea snakes. Use the pressure immobilization technique for a sea snake bite. Handling tourniquets care must be taken when removing tight tourniquets which most of the time used. Rational use of snake antivenom can substantially reduce mortality and morbidity due to snakebites. Sea snake envenomation is rare as they are infrequently aggressive and have a smaller apparatus to bite. Sea snake simple english wikipedia, the free encyclopedia. Assess abcs abcs and initiate appropriate resuscitation efforts. The main goal is to administer the correct antivenom as soon as possible. After giving the first aid, the bite should be inspected by a doctor. Management of venomous snake bites in north america. Inspect the area of the biteinspect the area of the bite, looking for fang marks, which may appear to. Although their venom is the most potent of all snakes, human fatalities are rare.
Guideline snake bite who 2016 perhimpunan dokter ahli. Snakebite first aid vanderbilt university medical center. Pdf management of snakebite an update researchgate. Agricultural workers and children are the most affected. Up to 50% of all venomous bites are reported to be dry bites, i.
As in previous releases this utilises minimal colour and may be printed easily from the pdf version in the electronic compilation. Guidelines for the clinical management of snake bite in the southeast asia region preface the geographical area specifically covered by this publication extends from pakistan and the rest of the indian subcontinent in the west through to the philippines and indonesia in the east, excluding tibet, china, taiwan, korea, japan, the eastern islands. The critical components of prehospital care for sea snake bites are initial stabilization with airway control, pressure immobilization of the bitten extremity, and prompt transport to a facility capable of providing advanced medical care including antivenom administration. They are found in warm coastal waters from the indian ocean to the pacific and are. Sea snake victims need to be moved to dry land to avoid drowning. The victim may receive all, a portion, or none of the venom when the snake strikes. Throughout the first aid treatment of the individual who has been bitten by a sea snake, make sure that the person remains calm. The incidence of snakebite mortality is particularly high in southeast asia. Snake bites management and treatment cleveland clinic. Poison control centers, zoos, or experts in snake envenomation may help guide the management of sea snake envenomations and assist with the location of antivenom.
If the snake is still attached use a stick or tool to make it let go. Sri lanka medical association colombo this print edition contains the text of the revised electronic guidelines version 3. The emergency care clinical network has updated this statewide guidance on managing snake bite envenomation or suspected snake bite. Efficacyofaconstrictive bandagewithlimbimmobilization inthemanagementof humanenvenomation. While all sea snakes are very venomous, most sea snakes have short fangs and mild temperaments unless provoked. Sea snakes are found predominantly in tropical and subtropical waters in the western pacific. Antivenom is the only effective antidote for snake venom. This may result in redness, swelling, and severe pain at the area, which may take up to an hour to appear. Rational use of snake antivenom can substantially reduce mortality and morbidity due to snake bites. The diagnosis and treatment of venomous snake bites is sometimes difficult for clinicians because sufficient information. Management of acute renal failure following russells viper.
Sudden removal can lead to a massive surge of venom leading to neurological. Snake bite or suspected snake bite is a rare but dangerous condition. Sea snakes, which comprise approximately 70 species, are the most abundant and widely dispersed group of poisonous reptiles in the world. Diagnosis of the species of snake responsible for the bite is important for optimal clinical management. Sea snakes bites could show anywhere from 1 to up to 20 fang marks. Panicking will not help as it can only distract the person providing the first aid treatment. The amount of venom injected if any cannot be predicted, and therefore, any suspected bite by a sea snake should be considered potentially lifethreatening and the person bitten should seek immediate medical attention. Even then, many only give a dry bite and do not inject venom. Antivenoms are made by immunizing a horse or sheep with the venom of a particular snake, then processing. Management of snakebite and research seares122 distribution. Himalayas,6 and sea snakes dive to depths greater than. The species identification does not really change the medically management at presen. Sometimes the onset maybe delayed for 10 hours or more.
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