Keterangan
Management of snake bites is a critical process aimed at minimizing the potential harm from venomous snakebites. Identifying the snake's species, if possible, can assist in determining the type and potential toxicity of the venom. The safety of the victim and the healthcare provider is paramount. Encourage the patient to remain calm and still to slow the spread of venom.
Immobilizing the bitten limb with a splint or bandage can help reduce venom spread. It should be done loosely to avoid further complications. Cleaning the bite wound with soap and water helps prevent infection. However, cutting the wound or applying suction is generally not recommended. Remove any constrictive items near the bite site, such as jewelry or tight clothing, which can impede blood flow. Keeping the bitten limb at or slightly above heart level may reduce swelling. Manage symptoms such as pain, swelling, and shock with appropriate medications and measures. In cases of venomous snake bites, antivenom may be administered to counteract the venom's effects. It should be administered in a healthcare facility under close supervision.
Ringkasan
- **Snake Identification and Types:** The lecture details various types of snakes, differentiating between poisonous and non-poisonous varieties. Poisonous snakes are categorized by their venom type: neurotoxic (affecting nerves), hematotoxic (affecting blood), and cytotoxic. Families like Elapidae, Viperidae, and Hydrophiidae are mentioned for poisonous snakes, while Colubridae, Boidae, and Pythonidae are discussed for non-poisonous snakes.
- **Snake Venom and its Effects:** Snake venom contains proteolytic enzymes, digestive properties, and substances like hyaluronidase and phospholipidase A2, which can damage cell membranes. Drinking venom is typically harmless unless there are ulcers in the gastrointestinal tract, allowing direct absorption into the bloodstream. Factors such as the snake's size, body weight, and the location of the bite influence the severity of the venom's effects.
- **Initial Response to Snakebite:** The initial reactions to a snakebite include shock, sweating, palpitations, and fear. It's not guaranteed there will be two puncture marks. Multiple teeth insertions can also be present. First aid principles: Reassurance, immobilization, immediate hospital transport, and relaying the symptoms to the doctor are key.
- **What NOT to Do After a Snakebite:** Actions to AVOID include attempting to suck out the venom, washing the wound, applying a tourniquet, or cutting the bite site. These can worsen the condition by increasing necrosis, embolism, or delaying proper medical attention.
- **Venomous vs Non-Venomous Bites:** Venomous snake bites can cause various symptoms, including drowsiness, difficulty breathing, swelling, necrosis, diarrhea, nausea, muscle weakness, and cardiac issues. These bites can also interfere with the coagulation cascade, leading to bleeding problems. Non-venomous bites lack the same systemic effects.
- **Anti-Snake Venom (ASV) Treatment:** In India, a single polyvalent ASV is used against the "big four" snakes. It is administered based on the patient's symptoms and lab reports, rather than identifying the specific snake. Treatment involves addressing the patient's condition, the lab results, and the patient's emotional state. A 20-minute whole blood clotting test is used to monitor the effectiveness of the ASV.
- **ASV Administration and Potential Reactions:** ASV is administered intravenously, diluted in isotonic saline or glucose. Allergic reactions can occur and should be managed with epinephrine, antihistamines, and corticosteroids. Dosage remains consistent, but the number of vials needed varies based on the severity of envenomation.
- **Managing Complications and Additional Treatments:** Complications of snake bites and ASV treatment can include shock, renal failure, and cardiac issues. Atropine and neostigmine are used for neuroparalytic symptoms. Muscle paralysis, breathing difficulties, and low blood oxygen may require oxygen supplementation and mechanical ventilation. Bleeding complications may necessitate transfusions of packed red blood cells or fresh frozen plasma.
- **Prevention and Public Health:** Snake bites are more common in rural areas and during the rainy season. Better ASV supply in rural hospitals is needed. Protocol for snake bite patients are required in hospitals along with research and snake bite treatment centers. It's important to remember that snakes typically bite defensively, and only a small percentage of snakes are venomous.
Contoh Sertifikat
Tentang Pembicara
Dr. Vijaypal Reddy Maddireddy
Konsultan Senior Pengobatan Darurat Rumah Sakit Vamsi, Anantapur
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