SPECTRUM OF COMPLICATIONS OF SNAKE BITES - A TERTIARY CARE HOSPITAL EXPERIENCE

Abstract

Objective: To highlight the spectrum of haematological, central nervous system complications and treatment outcome in cases of ophitoxaemia.

Material and Methods: This descriptive analytical study was carried out atCombinedMilitaryHospital, Kharian. All cases of ophitoxaemia admitted in Combined Military Hospital (CMH) Kharian cantonment from June 2007 to November 2008.

Results: During the study period a total of fifty cases of snake bites were admitted inCMH Kharian. These cases reported between June 2007 to Nov 2007 and then between June 2008 to Nov 2008. No case of snake bite reported from December 2007 till May 2008. There were 33 (66%) male and 17 (34%) females. The mean age was 34.8 years. The mean hospital stay was 5.06 days (maximum 13 days). There were 34 events of haematological complications and nine patients developed central nervous system (CNS) complications including respiratory failure in seven patients warranting mechanical ventilator support. Antivenom (AV) was administered to 32 patients only. Dose of AV ranged from 40-200 ml with a mean value of 37.29 ml. The administration of AV was associated with allergic febrile reactions in twenty five patients (78.1%). In this study four patients died with mortality rate of 8%.  The bite to needle time in the patients with fatal outcome was > 24 hours.

Conclusion: Snake bites are still associated with fatal outcome, mainly because of late administration of AV. Successful management of haematological and central nervous complications requires the availability of facilities for mechanical ventilator support and blood components.

Key Words: Ophitoxaemai, Complications, Haematological, Central Nervous system