Serious Adverse Reactions to Anti-snake Venom in Children with Snake Envenomation: An Underappreciated Contributor to Snakebite Mortality?

Abstract

A bstract Background Deaths due to snakebites and serious adverse reactions to anti-snake venom (ASV) are both underreported in India. Serious adverse reactions to ASV are common, contributing significantly to mortality and morbidity. We conducted a study to determine the frequency of occurrence of severe adverse reactions to ASV in children and study the various risk factors and their outcomes. Patients and methods We carried out a retrospective record review of all children of snake envenomation admitted in our tertiary care teaching hospital, from January 2013 to December 2016. Children aged 0 to 12 years admitted for snake envenomation and who received ASV as part of their treatment were included. Details about their management, including ASV usage and any adverse effects noted, were collected on a standard data collection form. Results Sixty-eight children were enrolled. Hemotoxic (52.9%) envenomation was more common than neurotoxic (35.2%). Severe adverse reactions were present in 42.6%, hypotension in 38.2%, and bronchospasm in 4.4% of the children. The overall mortality rate was 16.1%, anaphylaxis to ASV contributing to 36.3% of them. Mortality was significantly higher in cases with severe adverse reactions ( p = 0.005). ASV reactions were also significantly different with different manufacturers. Conclusions There is a high frequency of occurrence of severe adverse reactions to ASV resulting in significant morbidity and mortality. How to cite this article Hooda R, Parameswaran N, Subramanian M. Serious Adverse Reactions to Anti-snake Venom in Children with Snake Envenomation: An Underappreciated Contributor to Snakebite Mortality? Indian J Crit Care Med 2021;25(6):720–723.

Prácticas populares de prevención y tratamiento del accidente ofídico en Petén, Guatemala: estudio fenomenológico

“…La aplicación del suero antiofídico en el campo solamente está recomendada cuando la persona está muy lejos del hospital o cuando no exista otro recurso. En tales casos, esta debe hacerse por la vía intramuscular y la víctima debe ser trasladada inmediatamente al hospital pues dado que el suero antiofídico contiene proteínas de caballo, puede ocurrir una reacción anafiláctica que, si no es tratada, puede conducir a la muerte por choque anafiláctico (Asita et al, 2015;Hooda et al, 2021) En el imaginario de los nativos mesoamericanos, la persona fuerte -en contraposición con la persona débil-, puede sobreponerse a las enfermedades naturales y a las sobrenaturales, como el susto (Ghidinelli, 2002). Por otro lado, la actitud positiva aquí descrita cobra importancia cuando se trata de enfermedades como el accidente ofídico, que tienen un fuerte componente psicológico y que cursan con gran dolor e incomodidad (Guerra-Centeno, 2018b).…”