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
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