A comparative study between retrospective and prospective assessment of rationality and effectiveness of snake bite management in a tertiary care teaching hospital

Abstract

Background: Snake bite envenomation remains one of the commonest causes of mortality and morbidity in rural West Bengal. Objective of present study was to compare the rationality, effectiveness and adherence to standard treatment guidelines of Government of West Bengal of snake bite management over the high-risk periods of two years.Methods: This was a comparative study of snake bite management between 2016 and 2018 (over April to September) during peak risk season in a tertiary care teaching hospital in rural Bengal. The data was collected retrospectively from the treatment records in 2016 and from patients admitted with history of snake bite in the Medicine ward, ICU and ITU in 2018.Results: Records from 2016 yielded 177 snake bite patients (144 venomous and 82.5% neurotoxic envenomation) and in 2018, 190 cases (114 venomous and 71.1% neurotoxic). There was delay in presentation (>2 hours) in almost 80% cases in both years and 2.56% had anaphylactic reaction following ASV administration in 2018 against 3.15% in 2016. Ventilator support was necessary for 12% patients in 2018. Overall percentage of mortality reduced from 6.70% to 3.2% in 2018. Adherence to snake bite management STG was seen in 81.8% of the retrospective records vis a vis 80% cases in prospective analysis (p = 0.21).Conclusions: The survival rate in venomous snake bite is found to be high in this institution over last two seasons of snake bite. The practice of snake bite management is found to be adherent with standard protocol in most cases.

Trends in snakebite deaths in India from 2000 to 2019 in a nationally representative mortality study

“… Bhalla et al, 2009 Bhalla et al, 2014 Chattopadhyay et al, 2004 Chaudhari et al, 2014 Chauhan et al, 2005 Cherian et al, 2013 Datir et al, 2015 Deshpande et al, 2013 Gajbhiye et al, 2019 Gosavi et al, 2013 Government of Tamil Nadu, 2008 Gupt et al, 2015 Gurudut et al, 2011 Halesha et al, 2013 Harshavardhan et al, 2013 Innah, 2015 Jayakrishnan et al, 2017 Kirte et al, 2006 Korambayil et al, 2015 Kumar et al, 2018 Kumar et al, 2013 Longkumer et al, 2016 . Mandal et al, 2019 . Mishra et al, 2019 Mitra et al, 2015 Mittal et al, 2012 Monteiro et al, 2012 Nagaraju et al, 2015 Palappallil, 2015 Panda et al, 2015 Padhiyar et al, 2018 Pandey et al, 2016 Patil et al, 2013 Patil et al, 2011 Pore et al, 2015 Punde, 2005 Raina et al, 2014 Ramanath and Naveen Kumar, 2012 Ramesha et al, 2009 .…”