1 snake bite introduction

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Slide 1: 

Snake bite… introduction

Snakebite vs traditional healers : 

Snakebite vs traditional healers 80 – 90 % are safe 10 – 15 % dies Traditional healers uses this fact They identify neurotoxicity by bitter taste are irritant solution in eye---delay in treatment by making false belief of protection---delayed envenomed pt died at hospital are on the way to hospital Irulas in nilgiris know the fact and accepted ASV but others near by us…………..?

Epidemiology : 

Epidemiology Rural: urban ratio ---- 9:1 Monsoon and post monsoon season,floods… Young active peoples

SNAKE BITE - Facts : 

SNAKE BITE - Facts It is a major medical concern. In India, every one minute one person is bitten by a snake. Every two hours one person dies. In India, over four lakhs persons bitten by snakes every year. Envenomation in 82,000. Death occurs in 11,000.

SNAKE BITE – Facts : 

SNAKE BITE – Facts Many death occurs before the victim reaches the hospital. Most of the victims are young and the only bread winner.

Slide 6: 

All snakebite patients do not develop clinical symptoms and signs of envenomation reactions because snakes sometimes bite without injecting venom or inject too little venom to cause damage. Dry bite Late onset envenomation---hard tissue /juvenile snakes SNAKE BITE – Facts

SNAKE BITE – Facts : 

SNAKE BITE – Facts Site of action of venom varies from one snake to another. Complications due to snake bite may also vary from individual to individual. However, one has to observe for signs and symptoms which may develop within 24 to 48 hours.

Status of poisoning can’t be judged by : 

Status of poisoning can’t be judged by bite mark Local reaction size of the snake type of the snake. !? Time since snakebite

Classification : 

Classification Venomous Kobra (elapidae) Krait Russells viper(viperidae) Saw scaled viper Hump nosed pit viper Venomous sea snakes(hydropidae) Non venomous

Big four : 

Big four Indian cobra Common krait Russell’s viper Saw scaled viper ------ plus----HUMP NOSED PV

Slide 11: 


KING COBRA : 

KING COBRA --- KING SIZE UPTO 22 FTS --- UPTO 6 ml OF VENOME

KING COBRA : 

KING COBRA largest venomous snake in the world causes relatively few bites on humans. It appears to have a degree of intelligence

Slide 15: 

It avoids attacking another venomous snake for fear of being bitten. It feeds exclusively on harmless species.

Slide 16: 

The female builds a nest then deposits her eggs. Lying close by, she guards the nest .

Slide 17: 

She is highly aggressive toward anything that closely approaches the nest.

COBRA : 

COBRA @ SO CALLED NALLA PAMBOOO @6 IN TOP 10 DEADLY SNAKES OF THE WORLD @associated with Indian mythology and   are  worshipped across the country.@ RICE FIELDS @ MILK NOT AT ALL A FOOD @ EATS MOLE RATS(varappu eli) @ raise their head   and spread  their Hood in defense. @ BINOCULED MARK

KRAIT : 

KRAIT # SO CALLED KATTU VIRIAN # 3RD IN TOP10 DEADLY SNAKES OF THE WORLD # PRE SYNOPTIC MOST POISONOUS # LATE CLINICAL FEATURES AND LATE RECOVARY # RICE FIELDS/RUBBLES/PILES OF BRICKS/RAT BURROWS # EATS SUNDELI AND OTHER SNAKES # NEAR HUMAN DWELLINGS # NOCTURNAL # UPTO 1 METRE # BLACK/WHITE BELLY/PAIRED WHITE BANDS # LATE ONSET NEUROTOXICITY UPTO 24 HRS USUALLY 8 HRS

Slide 30: 

Kraits are found only in Asia. 15 times more deadly than the common cobra Habitat: Open fields, human settlements, and dense jungle.

Slide 31: 

venom is more toxic than   that of a cobra The snake often enters people’s houses in its quest to   find a cool place. People get bitten when they step on the snake   accidentally.

RUSSEL’S VIPER : 

RUSSEL’S VIPER $ SO CALLED KANNADI VIRIAN $ BIG BOY $ STOUT BODY UPTO 1.8 METRES $ BUSHES OF BOUNDARIES/UNDER THE TREE $ NOCTURNAL LIKE OTHER VIPERS $ EATS VELLELI $ KANNADI VIRIAN

Slide 35: 

Responsible for more human fatalities than any other venomous snake. It is irritable. When threatened, it coils tightly, hisses, and strikes with such speed that its victim has little chance of escaping.

SAW SCALED VIPER : 

SAW SCALED VIPER [] SO CALLED SURUTTAI PAMBOOO [] SOUTH INDIAN TYPE ---SMALL [] POSTURE IT ADOPTS WHEN IT AGITATES – FIGURE OF EIGHT WITH HEAD AT THE CENTRE [] MOVING AND HISSING LIKE SAW [] UPTO 40 CMS

Slide 42: 

It gets the name saw-scaled from rubbing the sides of its body together, producing a rasping sound.

HNPV : 

HNPV {} ONE OF THE TINIEST VENOMOUS SNAKES OF INDIA {} UPTO 30 CM {} NOT RESPONDING TO ASV {} COAGULOPATHY UPTO 3 WKS

Slide 51: 

COBRA RV KRAIT S H S N V P V

NEUROTOXIC : 

NEUROTOXIC KRAIT KRAIT LIKE @ RV Non responsive to neostigmine Pre synoptic COBRA Responsive to neostigmine Post synoptic

ASV : 

ASV COBRA 0.6 mg RV 0.6 mg SSV 0.45 mg KRAIT 0.45 mg

Slide 54: 

How to prevent…?

Slide 55: 

Occupational disease..!!

Slide 56: 

Farmers (rice) Plantation workers (rubber, coffee) Herdsmen Hunters Snake handlers (Snake charmers and in snake restaurants and traditional Chinese pharmacies) Fishermen and fish farmers Sea Snake catchers (for sea snake skins, leather)

Preventive Aspects : 

Preventive Aspects Be specifically vigilant about Snake Bite after rains, during flooding, at harvest times and at night. Try to wear proper shoes or boots and long trousers, especially when walking in the dark or in under growth. Use a light (torch, flash light or lamp) when walking at night. Avoid snakes as far as possible, including snakes performing for snake charmers. Never handle, threaten or attack a snake and never intentionally trap or corner a snake in an enclosed space.

Slide 58: 

Don't sleep next to brush, tall grass, large boulders, or trees. They provide hiding places for snakes. Place your sleeping bag in a clearing. Use mosquito netting tucked well under the bag. This netting should provide a good barrier.

Slide 59: 

Don't put your hands into dark places, such as rock crevices, heavy brush, or hollow logs, without first investigating Don't walk through heavy brush or tall grass without looking down. Look where you are walking. Don't pick up any snake unless you are absolutely positive it is not venomousDon't pick up freshly killed snakes without first severing the head. The nervous system may still be active and a dead snake can deliver a bite

Preventive Aspects : 

Preventive Aspects If at all possible, try to avoid sleeping on the ground. Keep young children away from areas known to be snake – infested. Avoid or take great care handling dead snakes or snakes that appear to be dead. Avoid having rubble, rubbish, termite mounts or domestic animals close to human dwellings, as all of these attract snakes.

Preventive Aspects : 

Preventive Aspects Frequently check houses for snakes and, if possible, avoid types of house construction that will provide snakes with hiding places. To prevent sea snake bites, fisherman should avoid touching sea snakes caught in nets and on lines. The head and tail or not easily distinguishable. Risk of bites to bathers and those washing clothes in muddy water of estuaries, river mouths and some coast lines. Use sticks when going through bushy areas.

Slide 62: 

Thank you