JIST

Abstract

Snake bite is a medical emergency requiring timely intervention. Apart from the panic attack and the local injury, snake bites have no adverse effects on the patient. The common cobra (Najanaja), Russell's viper, saw-scaled viper, and common krait are four of the 13 poisonous species that are known to exist. This was a cross-sectional study of patients who presented with snake bite envenomation admitted to a tertiary care centre in central Karnataka between July and December 2022. The objective of the study was to assess the clinical outcome in patients with snake bite envenomation based on their time of presentation after the snake bite to a tertiary care centre. The subjects were stratified into two groups based on their time of presentation as early and late presentation groups and the need for ASV (anti-snake venom), FFP (fresh frozen plasma), development of cellulitis, conservative or surgical measures required for cellulitis, development of other complications like AKI (acute kidney injury) and need for hemodialysis was compared in these two groups. Pregnant women and patients with less than 18 years of age were excluded from the study. After a primary and secondary survey, WBCT20 mins along with coagulation factors was noted in two groups, need for ASV, need for FFP, development of complications like cellulitis, AKI is compared in both groups along with management measures whether conservative or surgical, need for hemodialysis was compared in two groups. In this study, of 30 patients 76.6 % were males 26.6% ofthepatientswerebetween30-39 years of age.23 patients (76.6%) presented within 6h (early presentation).7 patients (23.4%) were in the delayed presentation group. WBCT  20 mins and coagulation profile was prolonged in all patients who presented late (more than 6h). 85.7% of patients who presented late required more than 20 vials of ASV whereas 30% of patients who presented early did not even require ASV. 57 % of patients who presented late required 12or more pints of FFP whereas 60% of the patients who presented early did not require FFP transfusion. 57% of patients (4 patients) who presented late died during the course of treatment whereas 86.9%of patients who presented early were conservatively managed. AKI developed in all patients who presented late and hemodialysis was required in all those patients who developed AKI. Snakebite is a medical emergency. Patients if brought early within a few hours of snake bite can be conservatively managed and those patients are less likely to develop complications like cellulitis and AKI and even death.