Original Research Article
Year: 2022 | Month: July | Volume: 12 | Issue: 7 | Pages: 189-194
DOI: https://doi.org/10.52403/ijhsr.20220728
Clinical Profile and Outcome of patients with Snake Envenomation at Bharatpur Hospital Nepal
Rohendra Pande1, Vijaya Prasad Paudel2, Kalyan Sapkota3, Rajesh Kumar Mandal4
1Consultant Emergency Physician, Department of Emergency Medicine and Pre Hospital Care,
HAMS Hospital, Kathmandu, Nepal
2Prof and Chief Consultant, Chitwan Hospital Pvt Ltd, Chitwan, Nepal
3 Senior Consultant Physician, Department of Internal Medicine, Bharatpur Hospital, Nepal
4Consultant Physician, Department of Internal Medicine, Bheri Hospital, Nepalgunj, Nepal
Corresponding Author: Dr. Rohendra Pande
ABSTRACT
Background: Snake bites are well-known medical emergencies requiring hospital admission. Krait and Cobra are common snakes leading to envenomation in Nepal. Timely identification of the envenomation leads to prompt treatment and decrease the morbidity and mortality. We aimed to study the clinical profile and outcome of patients with snake envenomation at Bharatpur Hospital, Nepal.
Materials and Methods: The Study was a descriptive cross-sectional study conducted in the Department of Medicine in Bharatpur hospital from April 2018 to September 2018. The patients of snake bites admitted with signs of neurological, hematological, local or regional envenomation were enrolled in the study. Clinical profile, duration of hospital stay and outcomes were noted and analyzed in the study.
Results: Out of 63 patients of snake bite, majority of snakes responsible for envenomation was due to Krait (38.1%) followed by Cobra (9.5%) and only 4 cases (6.3%) were due to Viper envenomation. The most common sign of presentation was Ptosis (69%) followed by difficulty in protruding tongue (42.9%). Mean number of Anti Snake Venom (ASV) vials required was 26.03. The mean duration of hospital stay in neuroparalytic cases was 46.8 hours while 60.5 hours in hematotoxic cases. There was a fatality rate of 11.1%.
Conclusion: Snakebite is a common life-threatening emergency in the study area. Majority of the patients were victims of Krait or Cobra bite. Early administration of ASV prevents respiratory paralysis after neuroparalytic snakebite. Timely intubation and mechanical ventilation in respiratory paralysis cases is life saving. The development of new and more effective Antivenom that better targets the species responsible for bites in the region would help in improving future patients’ outcome.
Key words: Envenomation, snakebites, emergency, Clinical profile .