| ID | 224 |
|---|---|
| Name | SNAKE-BITE |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | |
| Management | |
| Introduction | |
| History | |
| Etiology | |
| Clinical Features | Clinical feature: Pain at the site of the bite, nausea, vomiting, profuse sweating, thirst and collapse. There may be local redness swelling and extravasation of blood. |
| Preventions | |
| Treatment | Treatment: A. Genaral measures: 1. Immobilise the patient and apply torniquet proximal to the site of bite and suck out venom (after incision if needed) immediately. 2. The site of the bite should be cleansed and then left strictly alone; otherwise the risk of infection is increased. If skin necrosis occurs, sloughs should be excised (with skin grafts applied as appropriate if possible). 3. Hospitalization (specially in young children) whenever possible. 4. Maintain B.P byi.v fluid & blood transfusion if necessary. 5. Sedatives are required if the patient is apprehensive. 6. Appropriate antitetanus prophylaxis should be given taking account of the patient’s immune state. B. Specific management- 1. If there is a clear evidence of systemic poiso-ning, antivenom should be given in earlier stage, some local affects specially necrosis, may be avoided or minimised if antivenom can be given within 4 hours of bite. Depending on the severity of poisoning, 20-100ml antivenom is diluted in 2-3 volumes of isotonic saline. This is then given by slow intravenous infusion (15 drops per minute). 2. Inj. adrenaline (1:1000 solution) must be imme-diately available. If a reaction occurs the drip is stopped temporarily and 0.5ml adrenaline to be given i.m. Provided the adrenaline is given at the first sign of anaphylaxis, it is rapidly effective and the drip can be restarted with care. Several injections of adrenaline may be indicated. 3. Antihistaminic drug may be given i.m before the antivenom injection is started. 4. For children over 10 years and adults with no symptoms 2 hours after the bite- rest and antihistaminic drug is advisable. |
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