TREATMENT OF SNAKE BITE
FIRST AID
Reassure the victim
Make the victim lie flat with bitten limb below the heart level.
Remove shoes, rings, watches, jewelry and tight clothing from the bitten area
Immobilize the victim’s bitten limb using a splint and lightly put a bandage.
Get the victim to the nearest secondary or tertiary care hospital where antivenom can be provided.
Do not apply a tourniquet / wash the bite site with soap or any other solution to remove the venom/ make cuts or incisions on or near the bitten area.
All the patients should be kept under observation for a minimum of 24 hours.
Investigations
Clinical diagnosis – signs of envenomation
Twenty-minute whole blood clotting test (20WBCT)
Treatment Phase
Pain - oral paracetamol or tramadol.
Anti-snake venom (ASV) is the mainstay of treatment. Administered only if there is envenomation. No test dose reqd.
Liquid ASV requires a reliable cold chain and has 2-year shelf life. Lyophilized ASV, in powder form, has 5-year shelf life and requires only to be kept cool.
Prophylaxis for Anti-snake Venom Reactions
Two regimens are normally recommended, i.e. hydrocortisone (100 mg) + antihistamine or 0.25–0.3 mg adrenaline subcutaneously
Initial Dose
• Mild envenomation (systemic symptoms manifest > 3 hours after bite) neurotoxic/hemotoxic 8–10 Vials
• Severe envenomation (systemic symptoms manifest < 3 hours after bite) neurotoxic or hemotoxic 8 Vials
Each vial is 10 ml of reconstituted ASV.
Children should receive the same ASV dosage as adults.