Guidelines for the Management of Snakebites

Abstract

India is estimated to have the highest snakebite mortality in the world. World Health Organization (WHO) places the number of bites to be 83,000 per annum with 11,000 deaths. 1 Most of the fatalities are due to the victim not reaching the hospital in time where definite treatment can be administered. In addition, community is also not well informed about the occupational risks and simple measures which can prevent the bite. It continues to adopt harmful first-aid practices, such as tourniquets, cutting, and suction. Studies reveal that primary care doctors do not treat snakebite patients mainly due to lack of confidence. 2 At the secondary and the tertiary care level, multiple protocols are being followed for polyvalent anti-snake venom (ASV) administration, predominantly based on western textbooks.

Acute myasthenic syndrome following coral snake envenomation in the Caribbean: a harbinger for admission to the intensive care unit

“…For severe cases, intravenous infusion of neostigmine at 12 µg/ kg/hour can be administered. [1][2][3] Respiratory distress was resolved, and oxygen therapy and nebulisations were discontinued. The patient recovered and was discharged from hospital 5 days from admission.…”

“…Phospholipase A2 may cause myotoxicity and rhabdomyolysis. [1][2][3] Hypersalivation from envenomation by coral snakes is uncommon. In 2006 Bucaretchi et al 3 reported 1 case of moderate hypersalivation out of 11 (9.09%) cases of envenomwith Micrurus species in Brazil.…”

“…The glycopyrrolateneostigmine combination can also be used with success. [1][2][3] M. lemniscatus is a highly venomous coral snake indigenous to the forests of Brazil, Bolivia, Colombia, Venezuela, Ecuador, Guyana, French Guiana, Suriname, Argentina, Paraguay, Peru and Trinidad and Tobago. [1][2][3] M. lemniscatus characteristically has bright, bold-coloured rings, triad of black bands, small head, and a blunt and rounded snout (figure 1A).…”

“…[1][2][3] M. lemniscatus is a highly venomous coral snake indigenous to the forests of Brazil, Bolivia, Colombia, Venezuela, Ecuador, Guyana, French Guiana, Suriname, Argentina, Paraguay, Peru and Trinidad and Tobago. [1][2][3] M. lemniscatus characteristically has bright, bold-coloured rings, triad of black bands, small head, and a blunt and rounded snout (figure 1A). This is the first published case from the Caribbean of acute myasthenic syndrome following coral snake envenomation causing respiratory paralysis.…”

“…3 Snake bite is a neglected public health issue in the world, and education, improvement in healthcare and ongoing research are all essential. [1][2][3] Correction notice This article has been corrected since it was published Online First. The value of"Tetanus toxoid" has been corrected from "5 mL" to "0.5 mL" in table 1.…”