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Consultancy Corner: Rural areas prone to snakebite deaths due to poor

Snakebite is recognized as a neglected tropical disease by WHO as more than one lakh people die globally and India accounts for more than half of them. Although many cases of snake bite are still reported, there has been no change.

Consultancy Corner: Rural areas prone to snakebite deaths due to poor
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Dr R Sriram,Senior consultant - Emergency Department,Gleneagles Global

Chennai

Snakebite causes significant morbidity and mortality especially in rural areas due to geographical difficulties, lack of health care facilities, lack of education and less availability of anti-snake venom.


Not all snakes are poisonous but majority of the venomous snakes bites in India are caused by the four species-king cobra, common krait, russel viper and saw scaled viper. Toxins released by snakes can damage the muscles (cytotoxin), heart (cardiotoxin),nervous system (neurotoxin) or even can cause internal bleeding (hemotoxin). The symptoms of toxicity will be varied or sometimes mixed and is based on the individual species.


The symptoms includes typical fang marks, pain, swelling, redness, discoloration over the bite are, local tissue damage, involuntary closure of eyelids, internal bleeding, chest tightness, respiratory problems, disorientation and even death.


What should you must do in case of snake bite?


Do’s


  • Be composed
  • Try not to move the affected part
  • Remove any tight clothing
  • Restrict movement and move away from the snake
  • Transfer the patient to a hospital


Don’ts


  • Don’t suction the wound with your mouth
  • Don’t incise the wound site
  • Never place ice or any chemicals
  • Remove tight bandage around the bite area as it can damage the blood supply to the limb
  • Don’t touch the snake even when it appears dead, as their nervous system would still be functioning


Patients bitten by snake must be admitted immediately to a hospital. The patients without any symptoms will be kept under observation in the hospital for 8-12 hours to watch for any symptoms or lack of progression of the symptoms.


Primary care includes airway, breathing, circulation and evaluating the patients for signs of shock. The patient with signs of toxicity will be kept in the Intensive Care Unit and anti-venom would be initiated as soon as possible.


Blood tests will be done to check for bleeding tendencies, kidney function test, muscle damage. Anti-snake venom will be used if there are local reactions, tissue damage, neurotoxicity or any possibility of bleeding.


Prevention is by wearing proper footwear and do not try to touch snakes as they tend to strike when they feel threatened. The greatest challenge is to bring the patients at the earliest to the hospital and the availability of anti-snake venom. Proper education and awareness must be given to people especially in rural areas to prevent snake bite deaths.


Symptoms

  • Pain
  • Swelling
  • Discoluration near the wound
  • Internal bleeding
  • Chest tightness
  • Respiratory problems
  • Death

Treatment

  • Anti-venom
  • Evaluating patient for signs of shock
  • Checking the breathing process of patient
  • Blood test to check kidney and muscle damage

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