Snake Bite;Treat the Shock And Save the Kidney -with Low Dose Asv--A Practical Approach

Abstract

Morbidity and mortality due to snake bite is one of the important healthcare concerns in India especially in the rural population. Acute kidney injury which may or may not lead to chronic renal failure is one of the important risks of snake bite. We submit a study done over 3 years in the tertiary care hospital in Tamil Nadu which emphasizes on early hydration and low dose ASV as a measure for better clinical response and prevention of acute kidney injury. Aim Of The Study: The aim of the study is to prove that low dose ASV is useful in reducing the morbidity and mortality as per the national and world health organization guide lines Material And Methods: This is a prospective observational study in a tertiary medical care hospital ,Coimbatore in western part of Tamil Nadu , south India, between Jan 2013 to Dec 2015 with 1224 patients all are presented with history of snake bite and signs of envenomation exclusion criteria all patients with pre existing renal disease ,those who are on drugs like aspirin and clopidogrel, and patients with previous history of bleeding diathesis are excluded from this study Results: The average ASV administered was 10-15 vials much less than the prescribed maximum dose of 30 vials, even patients developed acute kidney injury need less dose to recover showing the efficacy of low dose ASV regimen Conclusion: Our study shows when carefully observe the signs and and symptoms, early hydration, prior treatment with steroids, anti histamines and low dose ASV is non inferior to high dose ASV in effectively treating snake bite patients as ASV neutralizes only unbound, free flowing venom. Keywords: Low dose ASV, Acute kidney injury,