Snake venom poisoning: experience with 633 cases

Abstract

Snake venom poisoning is a common medical emergency and the epidemiological features vary from region to region. We conducted a prospective study to review the epidemiology, treatment and outcome of snake venom poisoning in central Karnataka. Six hundred and thirty three cases of snake bite, seen in a teaching hospital, upto the age of 18 years, over a period of 8 years from 1985 to 1992 constituted the material for the study. Detailed history with special reference to the type of snake, circumstances leading to the bite and clinical consequences were studied and final outcome was noted. Males (n = 433) were bitten more often than females (n = 200). Two hundred and fifty six (40.4%) cases were in the age range of 11-15 years. The cases were seen during two periods, i.e., Oct, Nov, Dec (n = 210) and Apr, May, June (n = 199). Most (n = 506) were encountered in the lower limbs. Viper was the most common poisonous snake. Five hundred and seventy (90%) cases were from rural area. Coagulation time was prolonged in 371 (58.6%) cases, hemorrhagic syndrome was noticed in 354 (55.9%) cases, neurological involvement in 79 (12.5%) cases. Polyvalent anti snake venom (ASV) was given to 479 cases. Hypersensitivity to ASV was noted in 8 cases. Blood transfusion was given to 33 cases for the management of excessive bleeding. The death rate among snake victims was 5.2% (33 cases). The morbidity and mortality can be reduced substantially by increasing and maintaining confidence in good medical care and providing health education.