M A N A G E M E N T O F S N A K E B I T E S

ENVENOMING

LOCAL

• Fang marks • Local pain • Local bleeding • Bruising• Lymphangitis• Lymph node

enlargement• Inflammation (swelling,

redness, heat) • Blistering• Local infection, abscess

formation• Necrosis

SYSTEMIC

Specific

and Cardiovascular signs

symptomsBleeding and clotting

disorders NeurotoxicityRhabdomyolysis with

myoglobinuria Renal

Non specific

NauseaVomitingMalaiseAbdominal pain \WeaknessDrowsinessProstration

SIGNS OF ENVENOMING

IF ENVENOMED IF NOT ENVENOMED

(But a definite history ofbite by a venomous snake

and / or fang marks)

Localenvenoming

onl

Systemicenvenoming

y

Observe for at least 24 hours;Antivenom serum therapy Watch for signs of systemic

envenoming

If no signs of systemic envenoming develop discharge the patient

If signs of systemic envenoming develop treat with AVS

PATIENT WITH A SUSPECTED SNAKE BITE

• Commence AVS as soon as systemic envenoming has been detected

• Dose: 100 ml (10 ampoules) of Indian polyspecific AVS in 300 ml of normal salineinfused intravenously over one hour

• In Viper bites - AVS may be repeated in 6 hours if coagulopathy persists or bleeding

• In Cobra & Krait bites – Usually one dose of AVS is sufficient unless there is clinicalevidence of progression of neurological deficits or deteriorating neurotoxicity

• Local administration of antivenom at site of bite is not recommended.

AVS Therapy