First State Management for Snake Bite

Reassuring, Immobilizing, and Getting to Hospital

Slide1: Introduction

  • Snake bite management requires prompt action
  • First state management is crucial for patient safety
  • Two scenarios: site and hospital
  • Follow mnemonic 'Do it Right'

Slide2: Reassuring the Victim

  • Priority is to reassure the victim
  • Ensure them that everything will be fine
  • Stress that they will be taken to a hospital with snakebite facilities
  • Provide reassurance and comfort

Slide3: Immobilizing the Bitterness

  • Immobilize the bitten limb to prevent further venom spread
  • Apply a splint or wooden board if available
  • Use a crepe bandage or clothing to secure the limb
  • Bandage should be tight enough to occlude initial lymphatics

Slide4: Getting to the Hospital

  • Transport the victim immediately to a hospital with snakebite treatment facilities
  • Ensure availability of antivenom at the hospital
  • Inform the doctor about the signs and symptoms observed
  • Prompt transfer is vital for timely treatment

Slide5: Local Examination

  • Look for fang marks or scratch marks as signs of snake bite
  • Check for blister formation and swelling at the bite site
  • Inspect for localized lymphadenopathy near the bite area
  • Measure circumference of the limb for monitoring swelling

Slide6: Systemic Examination

  • Neurotoxic envenomation: look for diplopia and ptosis
  • Hemotoxic envenomation: check for conjunctival hemorrhage and bleeding
  • Monitor respiratory parameters and single breath count
  • Assess for signs of impending respiratory failure

Slide7: Investigations

  • Perform 20 minutes whole blood clotting time test
  • Consider point-of-care PT/INR testing if available
  • Additional investigations: complete blood count, urine routine, renal function
  • Assess for coagulation abnormalities and kidney injury

Slide8: Indications for Antivenom

  • Systemic indications: respiratory symptoms, bleeding, rapidly increasing swelling
  • Positive 20 minutes whole blood clotting time or abnormal PT/INR
  • Local indications: rapidly increasing swelling, lymphadenopathy
  • Start antivenom with 6-10 vials at 1-2 ml per minute

Slide9: Management in the Hospital

  • Ensure airway, breathing, and circulation
  • Monitor vital signs and respiratory parameters
  • Repeat single breath count every 15-20 minutes
  • Administer anti-allergic medication if needed

Slide10: Additional Management

  • Administer tetanus prophylaxis to all snake bite patients
  • Prescribe antibiotics for coverage against gram-positive bacteria
  • Observe patients for a minimum of 24 hours
  • Address complications like compartment syndrome and renal failure

Slide11: Conclusion

  • First state management is vital for snake bite patients
  • Reassure and immobilize the victim, get to hospital
  • Conduct thorough local and systemic examinations
  • Initiate antivenom and monitor closely in hospital

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