STUDY OF TREATMENT STRATEGIES AND OUTCOME OF SNAKE BITE IN CHILDREN AT A TERTIARY CARE HOSPITAL
Dr. Deepa S. Phirke* and Dr. Nazparveen L. A.
Introduction: Snake bite is a common medical emergency especially in tropical and sub-tropical countries. The estimated deaths in india due to snake bites is about one in one lakh population. Snake venom composition differs from species to species and leads to a diversified clinical manifestation and outcome due to snake bite(Ophitoxemia). Children are more prone for complications due to physiological vulnerability. Hence there is a need to study the outcome of Ophitoxemia in children. Materials and Methods- It is an prospective observational study conducted in a tertiary care hospital. All paediatric patients with snake bite were included .Details of time, Month, Site and type of snake bite, Clinical manifestations, complications and treatment received were noted. The data was analysed. Results- Out of total 48 cases in study, 93.75% had pain and 87.5% had anxiety.58.33 % had non poisonous snake bite.50% cases did not require ASV. Respiratory failure was detected in 6.25% cases, all of which required Mechanical ventilation. Acute renal failure and DIC was observed in 1 (2.08%) case each. Out of 8(16.66%) neuro paralytic snake bites, all required neostigmine-atropine regime,3 required Mechanical ventilation. Out of 12(25%) vasculotoxic snake bites, only 3 cases required blood products. The mortality rate was 6.25%, all of which had neuroparalytic snake bite. Discussion- The commonest clinical feature was pain followed by anxiety. Majority of the patients had non poisonous snake bite hence most of them did not require ASV. Respiratory failure was the commonest complication observed which required mechanical ventilation. Mortality was mainly due to neuroparalytic snake bites with respiratory failure. Conclusion- Mortality was more in patients with poisonous snake bite with complications. Thus such patients should be treated aggressively with ASV and supportive treatment right from the begining, to reduce the mortality.[Full Text Article]