Bite-to-needle Time – An Extrapolative Indicator of Repercussion in Patients with Snakebite

Jayaraman, Thamizhkumaran; Dhanasinghu, Raju; Kuppusamy, Santhanam; Gaur, Archana; Sakthivadivel, Varatharajan

doi:10.5005/jp-journals-10071-24344

Cited by 3 publications

(1 citation statement)

References 20 publications

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“…While under 6 h is loosely described as the treatment time target [ 15 , 31 , 36 ], this has not been clearly defined, with studies reporting different time frames. Jayaram et al [ 16 ] report a “bite to needle” time of more than 6 h as having worse outcomes, such as longer hospital stays, more antivenom required, and higher complication rates. The mortality rate in patients who received antivenom for more than 24 h after the bite was high (8/12 patients).…”

Section: Delays To Treatmentmentioning

confidence: 99%

Clinical Risk Factors Associated with Poor Outcomes in Snake Envenoming: A Narrative Review

Wood

2023

Toxins

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Snakebite-related fatalities disproportionately affect populations in impoverished socio-economic regions, marked by limited access to adequate healthcare and constrained antivenom availability. Early medical intervention is pivotal in mitigating mortality and morbidity associated with snakebite envenoming (SBE). While clinical assessment remains fundamental in treating SBE, this review aims to spotlight objective parameters that could also affect outcomes. Selected studies that identify factors associated with poor outcomes are predominantly region-specific, single-site, and observational, yet collectively reveal similar findings. They consistently report factors such as treatment delays, susceptibility in vulnerable groups such as children and pregnant women, as well as various biochemical and haematological abnormalities. Acute kidney injury (AKI), low platelets, leucocytosis, abnormal coagulation, and elevated creatine kinase (CK) all show an association with poor outcomes. Furthermore, recognising rare and unusual SBE presentations such as adrenal insufficiency, severe hypertension, intracranial haemorrhage, acute angle closure glaucoma, and bowel ischaemia also has a bearing on outcomes. Despite the integration of these parameters into clinical decision tools and guidelines, the validation of this evidence is limited. This review underscores the imperative for high-quality, multi-centre studies aligned with consensus-driven Core Outcome Sets (COS) and Patient-Reported Outcome Measures (PROMS) to validate and strengthen the current evidence.

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Section: Delays To Treatmentmentioning

confidence: 99%

Clinical Risk Factors Associated with Poor Outcomes in Snake Envenoming: A Narrative Review

Wood

2023

Toxins

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Snakebite Management: The Need of Reassessment, International Relations, and Effective Economic Measures to Reduce the Considerable SBE Burden

Kumar,

Rathore

2024

J Epidemiol Glob Health

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The sole treatment for snakebite envenomation (SBE), the anti-snake venom (ASV), suffers from considerable drawbacks, including side effects and limited species specificity. Additionally, despite its existence for more than a century, uniform availability of good quality ASV does not yet exist. The present review describes the journey of a SBE victim and highlights the global crisis of SBE management. A detailed analysis of the current ASV market has also been presented along with the worldwide snake distribution. The current production of country specific licensed ASV throughout the globe along with their manufacturers has been examined at the snake species level. Furthermore, a detailed analysis of on-ground situation of SBE management in antivenom manufacturing countries has been done using the most recent literature. Additionally, the export and import of different ASVs have been discussed in terms of procurement policies of individual countries, their shortcomings, along with the possible solution at the species level. It is interesting to note that in most countries, the existence of ASV is really either neglected or overstated, implying that it is there but unsuitable for use, or that it is not present but can be obtained from other countries. This highlights the urgent need of significant reassessment and international collaborations not just for development and production, but also for procurement, distribution, availability, and awareness. A PROMISE (Practical ROutes for Managing Indigenous Snakebite Envenoming) approach has also been introduced, offering simple, economical, and easy to adopt steps to efficiently alleviate the worldwide SBE burden.

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Reported snakebite mortality and state compensation payments in Madhya Pradesh, India, from 2020 to 2022

Kadam,

Patel,

Gopalakrishnan

et al. 2024

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Background India experiences the highest snakebite burden globally, with 58 000 predicted deaths annually. The central Indian state of Madhya Pradesh is thought to have a substantial snakebite burden and provides compensation to families who can demonstrate by postmortem and hospital treatment reports that their relatives have died due to snakebite. This study represents the first report on the frequency of distribution of compensation for snakebite deaths in Madhya Pradesh. Methods Statewide snakebite death compensation data from 2020–2021 and 2021–2022, provided by the Madhya Pradesh health authorities, were analysed alongside interviews with 15 families that described the events that ultimately led to their compensation claims. Results Compensation was paid to a total of 5728 families, with a total value equating to 22 912 Lakhs (approximately US${\$}$27.94 million). Families described commonly recognised snakebite risk factors and behaviours in the events that resulted in their relatives’ deaths. Conclusions The snakebite burden in Madhya Pradesh is significant, both in terms of mortality and economic expenditure of the state. Sustained investment in preventative interventions, as well as monitoring of the rate of compensation payouts due to snakebite death as a measure of intervention effectiveness, should be considered to substantially reduce snakebite incidence and mortality.

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Bite-to-needle Time – An Extrapolative Indicator of Repercussion in Patients with Snakebite

Cited by 3 publications

References 20 publications

Clinical Risk Factors Associated with Poor Outcomes in Snake Envenoming: A Narrative Review

Clinical Risk Factors Associated with Poor Outcomes in Snake Envenoming: A Narrative Review

Snakebite Management: The Need of Reassessment, International Relations, and Effective Economic Measures to Reduce the Considerable SBE Burden

Reported snakebite mortality and state compensation payments in Madhya Pradesh, India, from 2020 to 2022

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