A retrospective review of snake bite victims admitted in a tertiary level teaching institute
M Rajesh Kumar1, M Veeraprasad2, P Ramesh Babu1, S Satish Kumar3, BV Subrahmanyam4, P Rammohan5, M Srinivas3, Amit Agrawal6
1 Department of Medicine, Narayana Medical College Hospital, Chinthareddy Palem, Nellore, Andhra Pradesh, India
2 Department of Hospital Administration, Narayana Medical College Hospital, Chinthareddy Palem, Nellore, Andhra Pradesh, India
3 Department of Emergency Medicine, Narayana Medical College Hospital, Chinthareddy Palem, Nellore, Andhra Pradesh, India
4 Department of Forensic Medicine, Narayana Medical College Hospital, Chinthareddy Palem, Nellore, Andhra Pradesh, India
5 Department of Pharmacology, Narayana Medical College Hospital, Chinthareddy Palem, Nellore, Andhra Pradesh, India
6 Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddy Palem, Nellore, Andhra Pradesh, India
M Rajesh Kumar
Department of Medicine, Narayna Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
Objective: Snake bite remains major public health problem worldwide. We present our experience with cases of snake bites managed in our tertiary care teaching center of South India.
Materials and Methods: The details of all patients with snake bite admitted to a tertiary teaching care hospital from 2010 to 2012 were retrospectively retrieved and reviewed. The details regarding age, gender, first aid received or not, time elapsed between the bite, emergency care management and ASV (Anti Snake Venom) administration, site of snake bite, clinical features at the time of presentation, local examination findings at the site of bite, duration of hospital stay, need for elective ventilation, details of investigations and outcome were reviewed. The data were analyzed in PSPP software (Free Software Foundation, Inc.) for window for statistical analysis, while standard deviation (SD) was applied for the continuous variables, and proportions were applied for the categorical variables.
Results: Mean age was 38.4 ± 14.8 years (range 4-70 years). Majority [72 (82.8%)] were farmers. In 86.2% patients, the site of bite was in lower limbs. Snake could be identified in only 20 cases [Cobra-12 (60%), Krait-2 (10%), and Viper-6 (30%)]. Mean time to reach to hospital was 12.1 ± 21.4 hours (range 1-120 hours). Mean anti-venom therapy duration was 3.2 ± 2.0 days (range 1-14 days). Mean hospital stay was 4.7 ± 3.1 days (range 1-15 days). Majority (72.4%) made good recovery; mortality was in 4.6% cases, and 20 (23%) patients left against medical advice.
Conclusions: This study identified major epidemiological and management variables related to snake bite. There is a need for a well-planned data collection and information dissemination system to avoid this potentially preventable disease.