Snake bite

Snake bite

Snake bite

Facts about Snake bite

  • Pit vipers (rattlesnakes, copperheads, cottonmouths, and massasaugas) are responsible for 99% of all snakebite poisonings; coral snakes and other foreign exotic species are responsible for the additional 1%. 
  • More than 1 million cases per year (India)

First Aid

  • Reassure the victim (70% of all snakebites are by nonvenomous snakes and 50% of bites by venomous species are dry bites….more
    • Immobilize the affected limb (by bandage or clothes to hold splint, but tight arterial compression is not recommended)
    • Promptly transfer of victim to hospital
  • Snakebite in Australia: a practical approach to diagnosis and treatment….more
  • Accurate identification of the pit viper species involved in snakebites is essential. Although envenomation by a rattlesnake (Crotalus species) may require antivenom and uncommonly surgery, a bite by a copperhead (Agkistrodon contortrix) rarely requires any intervention other than observation. The unnecessary use of antivenom should be discouraged....more
  • Awareness of Snake bite and its first aid management in rural areas of Maharashtra...more

Treatment for Snake bite

  • Different type of bites and diagnosis…more
  • Emergency treatment of a snake bite: Pearls from literature….more
  • Pretreatment with low-dose adrenaline found to be safe and reduced the risk of acute severe reactions to snake antivenom….more
  • Heparin seems to be having a beneficial role which needs to be confirmed by larger trials….more
  • WHO/SEARO Guidelines for the clinical management of snake bites in the Southeast Asian region….more

What does not work

  • Study do not support routine administration of a single dose of prednisolone 1 mg/kg subcutaneously in dogs bitten by Vipera berus...more
  • The routine use of antibiotics (penicillin and metronidazole) does not seem to be of value in reducing the local inflammatory swelling in venomous snakebite….more
  • Use of orally-administered chloramphenicol for victims of Bothrops snake bite with signs of local envenoming on admission, is not effective for the prevention of local infections...more
  • The study suggests that suction is unlikely to be an effective treatment for reducing the total body venom burden after a venomous snakebite….more
  • Prophylaxis with a parallel hydrocortisone infusion alone is ineffective in reducing the occurrence of acute adverse reaction to antivenom serum, but combining it with chlorpheniramine seems efficacious…..more

Anti-snake venom producers

  • Anti-snake venom producers in India: 
    • Central Research Institute (CRI), Shimla Hills, Kasauli, HP
    • Haffkine Biopharmaceutical Company Ltd (HBPCL), Mumbai 
    • King’s Institute of Preventive Medicine (KIPM), Chennai
    • Bengal Chemicals and Pharmaceuticals Ltd., Kolkata
    • Serum Institute of India Ltd. (SII), Pune
    • VINS Bioproducts Ltd., Hyderabad
    • Biological E Ltd., Hyderabad
    • Bharat Serum and Vaccine Ltd.
  • WHO guidelines for the production control and regulation of snake antivenom immunoglobulins...more
  • List of antivenoms producers over the world...more

Systematic reviews

  • Low-dose snake antivenom (SAV) is equivalent or may be superior to high-dose SAV in management of poisonous snake bite….more
  • Snake bite in Australia: first aid and envenomation management...more
  • A pharmacological approach to first aid treatment for snakebite….more
  • Snakebite Mortality in India: A Nationally Representative Mortality Survey...more

Treatment with Medicinal Herbs

  • Upland cotton (Gossypium hirsutum) – Dose – 100 g root/1 liter water, reduced by boiling to 0.5 liter, take 50 g liquid every half; 3 leaves in 1 liter water for hypertension; 6-8 g seed/150 g water or milk 
  • Tuliptree (Liriodendron tulipifera)– Dose – 0.5 oz powered root bark/pint water and fortified in alcohol, adult take half or whole wineglass full 3x/day before meals; 60 g bark decoction (30:500/day) 
  • Velvetleaf (Cissampelos pareira) – Dose – 0.5 – 1.5 g powered root; 28-56 ml root decoction; 2-8 ml liquid root extract 
  • Winged Prickly-Ash (Zanthoxylum armatum) – Dose – 0.6-12 g powdered fruit; 1-3 g powered bark; 28-56 ml bark tea 

Reference: Handbook of Medicinal Herbs (2006)

Herbals

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