Abstract
Introduction: Snakebite is well known medical emergencies and cause of hospital admission with significant mortality in our country. Objective of this study is to find out the status and outcome of snake bites envenoming management.
 Methods: This is prospective observational study from 15th April 2018 to 14th April 2019.Data collected all snake bites presented this hospital and observed till discharged, death or referred. Case management was done as per the WHO guideline for the management of snake bite 2016. Permission for study was taken from Medical Superintendent of Seti provincial hospital and informed consent was taken. The data were entered in Microsoft Excel 2007 and analyzed using latest version of SPSS version and appropriate descriptive statistical tools.
 Results: A total of 362 snakebites were landed in the emergency of this hospital during one year period among them 71% non-poisonous and 29% poisonous snake bites. There were 17 deaths (case fatality rate 12%). Among poisonous Krait 36 % were identified snakes and half could not. Major features of envenoming were ptosis,nausea,vomiting and pain abdomen, parotid tenderness, numbness and blister and bleeding in bitten parts. Almost all 86% poisonous bites got 100ml snake venom antiserum. Few cases required additional 10 vials (100ml) and 13.5% required ventilation for respiratory paralysis. There was no mortality in Intensive Care Unit and ward.
 Conclusions: Snake bite is the seasonal life-threatening emergency public health problem; significant numbers of snakebite and mortality but timely intervention has excellent outcome. Community awareness and strengthening health systems are major activities to be done.
Highlights
Snakebite is one of the most common occupational hazards causing life-threatening medical emergencies in Nepal
This is a prospective observational study conducted in Seti Provincial Hospital, Dhangadhi, Kailai, Nepal, which is a secondary level hospital of Far Western Province from 15th April 2018 to 14th April 2019
Examination, and relevant investigations were done to find out the poisonous snakebite envenoming and its complication
Summary
Snakebite is one of the most common occupational hazards causing life-threatening medical emergencies in Nepal. World Health Organization concluded that, though the exact number of snake bites is unknown, an estimated 5.4 million people are bitten each year with up to 2.7 million envenomings worldwide.[1] Annual deaths by snakebite envenoming are around 81 000 to 138 000 people and around three times as many amputations and other permanent disabilities. Emergency department data of snakebite records of the previous year of this hospital showed significant morbidity and mortality. Snakebite is a well-known medical emergency and a cause of hospital admission with significant mortality in our country.
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