Abstract
International Journal of Medicine and Public Health,2017,7,1,47-50.DOI:10.5530/ijmedph.2017.1.8Published:March 2017Type:Original ArticleProcurement and Supply of Anti Snake Venom as a Determinant of Snake Bite Management Outcome at a Government Medical College Hospital in KarnatakaSiddaya Ramakrishna, and Puttamaligaiah Subhas Babu Siddaya Ramakrishna1, Puttamaligaiah Subhas Babu2 1Department of General Medicine, Mandya Institute of Medical Sciences, Mandya, Karnataka, India 2Department of Community Medicine, Mandya Institute of Medical Sciences, Mandya, Karnataka, India Abstract:Context: Snake bite poisoning, is an important reason for hospitalization and death in rural India. Availability and timely administration of anti snake venom (ASV) at hospitals is an important factor in favourable prognosis for snake bite victims. Aims: To determine i. proportion of venomous bites to non venomous bites ii. proportion of snake bite cases administered Anti snake venom iii. supply and utilization of Anti snake venom in one year period for treating snake bite victims Settings and Design: A Cross sectional, study was conducted in a Government Medical college hospital in Mandya, Karnataka from November 2012 to October 2013 to ascertain ASV utilization. Methods and Materials: Data was collected from hospitalized snake bite victims, from medico legal register (deaths) and in-patient records. Information on ASV stock and supplies, was obtained from the hospital main stores and ward indents. Statistical analysis used: Frequencies and Proportions. Results: 376 (n) snake bite cases were admitted to the hospital during the period, of which 77 victims (20.47%) had envenomation (including 4 deaths). Of 920 anti snake venom vials procured and supplied to the hospital, 915 vials were used, of which 531 vials (58.03%) were administered to those correctly diagnosed to have envenoming. 189 (50.13%) victims who were later diagnosed not to have envenoming, received 384 vials (41.97%). Conclusion: ASV utilization is complete and on a few occasions excessive. All cases of envenoming were not given 10 vials of ASV as suggested in the protocol. Some cases received 2 vials at admission and recovered. Keywords:anti-snake venom, envenoming, mismatch, stock, supply, UtilizationView:PDF (233.58 KB)
Highlights
Worldwide envenoming and deaths due to snakebites ranges from 421,000 and 20,000 respectively to as high as 1,841,000 envenomings and 94,000 deaths annually
Total number of snake bite cases admitted to Mandya Institute of Medical Sciences (MIMS) hospital during the period – 376 (n) Of all the 376 patients who came with a history of snake bite, a total of 77 (20.48%) patients were confirmed to have envenoming of which 4 (1.06%) patients died due to Recieved anti snake venom (ASV) Did not receive ASV Total
A total of 264 (70.74%) snake bite victims including those confirmed of snake bite poisoning (n=75) were administered anti snake venom based on the history of snake bite and presence of fang marks (2 snake bite victims who were brought dead are not included in those administered ASV)
Summary
Worldwide envenoming and deaths due to snakebites ranges from 421,000 and 20,000 respectively to as high as 1,841,000 envenomings and 94,000 deaths annually. The most complete data suggest that envenomed bites constitute 18% and 30% of the total snake bites in India and Pakistan, respectively. Poisoning due to snake bite is an important reason for hospitalization and death in rural India. In India 45,900 deaths were attributed to snake bite in 2005 (99% CI 40,900 to 50,900) or an annual agestandardized rate of 4.1/100,000 (99% CI 3.6–4.5), with higher rates in rural areas (5.4/100,000; 99% CI 4.8–6.0). Karnataka has been categorized as a high prevalence state for snake bite deaths with annual snake bite death rate of 4.2 per 100,000 population.[2]
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