Venomous snakebites and antivenom treatment according to a protocol for pediatric patients in taiwan

Wang, Jiaan-Der; Tsan, YT; Mao, Yan‐Chiao; Lm, Wang

doi:10.1590/s1678-91992009000400006

Cited by 18 publications

(15 citation statements)

References 22 publications

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“…We bring a result of retrospectively collected data on clinical profile of snake bites in children from central [12][13][14][15][16]. Incidence was more in boys (58.75%) as compared to girls (41.25%) this is in accordance with other studies where high incidence is reported in male children which can be attributed to their behavior and nature to playmore outdoor games [17][18][19].…”

Section: Discussionsupporting

confidence: 74%

Clinical profile and outcome of snake bite in children

et al. 2019

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Background: Snake bite is generally considered to be a rural problem and has been linked with environmental and occupational condition is a neglected public health problem. This study was conducted to ascertain clinical profile, complication and outcome of snake bite in pediatric population. Methods: Retrospective observational study was done in Paediatrics wards and Paediatric Intensive care unit of tertiary care institute. A medical record files of 200 patients of snakebite, between the periods of January 2013 to August 2018 were recovered from Medical Record and Statistics Section of Institute. Files were analyzed for demographic data; variables included site of bite, time of bite, type of primary treatment and treatment provider, and type of snake poison, common symptoms suggestive of hematotoxicity, myotoxicity and neurotoxicity. Results: Out of total 200 patients, 59.0% were male and most of snake bites were seen in age group of 6-12 years. All bites were nonprovocative and in 57.5% lower limb was the commonest site of bite. A 81.5% patient were primarily treated by medical personnel, 56.5% patients were received treatment within 1 hour of bite and hospitalized within 6 hours of bite. Cellulitis was commonest complication (39.0%) followed by vasculotoxicity (30%) and neuroparalysis in (27.5%), followed by respiratory paralysis in (19.0%), coagulation (17.0%). Renal replacement therapy was required in 6.5%, blood/blood product transfusion in 11% patients and case fatality rate was 11.5%. Conclusions: The most vulnerable to snake bites are boys aged more than 5 years. There is an urgent need to spread awareness among the community for avoidance of traditional treatment and any delay in medical intervention in snakebite incidents.

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Section: Discussionsupporting

confidence: 74%

Clinical profile and outcome of snake bite in children

et al. 2019

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“…11 The TPCC guideline for treatment of snakebites patients only briefly described the symptomatic approach to diagnosing the culprit snake and then use of the correct antivenoms. 12 The usage of the FH antivenom is recommend as 1 vial antivenom to treat green habu (Viridovipera stejnegeri) bitten patients and 1e4 vials to treat the Taiwan habu (Protobothrops mucrosquamatus) bitten patients; while from six to 10 vials FN antivenoms were recommend to treat the Chinese cobra (Naja atra) bitten patients, and 1e4 vials to treat the Taiwan banded krait (Bungarus multicinctus) bitten patients. However, there is no clinical symptom severity grading systems described to guide the first antivenom dosage.…”

Section: Discussionmentioning

confidence: 99%

An investigation of snakebite antivenom usage in Taiwan

Lin

Chaou

Tseng

2016

Journal of the Formosan Medical Association

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“…Similar observations are reported in Indian and world literature. 16,17 In present study, 59.57% patients were primarily treated by medical personnel, 26.70% by paramedical people and 12.70% by tantric. Death of 6 patients in our study was due to delay in seeking primary treatment as these cases resorted to tantric measures or paramedical people for their treatment leading to delay in hospitalization.…”

Section: Discussionmentioning

confidence: 48%

Snake bite, a neglected menace: a prospective observational study in a tertiary care pediatric intensive care unit

Giri

Bisoi

Dash

et al. 2020

Int J Contemp Pediatr

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Background: Snake bite is a neglected and underestimated public health problem in tropical and subtropical region. Snake envenomation is a well-known cause of morbidity and mortality in India. In 2009, WHO declared snake bite a neglected disease. Ophitoxaemia is an exotic term characterising the clinical spectrum of snake bite. Objective of this study was to know the outcome in paediatric snake bite cases in a tertiary care PICU (Paediatric Intensive Care Unit) with special reference to envenomation time and also to evaluate and analyse few atypical presentations of snake envenomation by proper history taking, physical examination and help start early intervention to prevent morbidity and mortality.Methods: A prospective observational study was done in Paediatric Intensive care unit of the hospital from June 2017 to June 2019.Results: Around 56.8% of 109 cases were non-poisonous snake-bites. Out of 47 cases admitted to PICU, 68.08% developed cellulitis at the site of bite with Staphylococcus aureus being the commonest organism isolated (56.25%). Anaerobes (bacteroides and clostridium) were also isolated in few cases. Edema at site of bite (hematotoxic) and ptosis(neurotoxic) were most common initial presentation. 36.17% of patients received ASV (Anti- Snake Venom) and first aid within 6 hours of snake bite. The morbidity and mortality were significantly less (p<0.05) as compared to those who didn't receive ASV. 12.76% of cases with normal CRT (Clot Retraction Time) presented with features of coagulopathy. DIC (58.33% of hematotoxic bites) and respiratory paralysis 68 (75% of neurotoxic bites) were the commonest complications. Renal replacement therapy was required in 6.38%, transfusion in 10.63% cases and case-fatality-rate was 12.7%. There were a few atypical presentations of snake bite mimicking Gullain-Barre syndrome, acute onset encephalitis with absent brainstem and pupillary reflexes, intracerebral hemorrhage and cortical blindness.Conclusions: Most snake bites are non-poisonous. Early first aid and ASV administration has better outcome. Fibrinogen levels are more reliable than CRT to diagnose coagulopathy. Acute presentations i.e, altered sensorium, paralysis, blindness and stroke like features should always be evaluated for snake envenomation in suspected cases to prevent morbidity and mortality.

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Venomous snakebites and antivenom treatment according to a protocol for pediatric patients in taiwan

Cited by 18 publications

References 22 publications

Clinical profile and outcome of snake bite in children

Clinical profile and outcome of snake bite in children

An investigation of snakebite antivenom usage in Taiwan

Snake bite, a neglected menace: a prospective observational study in a tertiary care pediatric intensive care unit

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