The Protocol of Choice for Treatment of Snake Bite.

Afshin Mohammad Alizadeh,Mitra Rahimi,Behrooz Hashemi Domeneh,Hossein Hassanian-Moghaddam,Nasim Zamani,Mohammad Mashayekhian,Peyman Erfantalab,Ali Ostadi

doi:10.1155/2016/7579069

Abstract

The aim of the current study is to compare three different methods of treatment of snake bite to determine the most efficient one. To unify the protocol of snake bite treatment in our center, we retrospectively reviewed files of the snake-bitten patients who had been referred to us between 2010 and 2014. They were contacted for follow-up using phone calls. Demographic and on-arrival characteristics, protocol used for treatment (WHO/Haddad/GF), and outcome/complications were evaluated. Patients were entered into one of the protocol groups and compared. Of a total of 63 patients, 56 (89%) were males. Five, 19, and 28 patients were managed by Haddad, WHO, or GF protocols, respectively. Eleven patients had fallen into both GF and WHO protocols and were excluded. Serum sickness was significantly more common when WHO protocol was used while 100% of the compartment syndromes and 71% of deformities had been reported after GF protocol. The most important complications were considered to be deformity, compartment syndrome, and amputation and were more frequent after the use of WHO and GF protocols (23.1% versus 76.9%; none in Haddad; P = NS). Haddad protocol seems to be the best for treatment of snake-bitten patients in our region. However, this cannot be strictly concluded because of the limited sample size and nonsignificant P values.

Highlights

Snake bite is a common and very important health problem in many parts of the world including our country [1, 2]
Different protocols exist to manage snake bite, some of the very commonly used ones of which are the protocols suggested by the World Health Organization (WHO), Goldfrank’s Toxicologic Emergencies (GF) textbook (Figure 1), and Haddad and Winchester’s (Haddad) Clinical Management of Poisoning and Drug Overdose textbook (Figure 2) [5,6,7]
In a try to unify the protocol of snake bite treatment in our center, we reviewed the files of the snake-bitten patients and compared the outcome and frequency of complications between them to determine which protocol was probably the best for the management of these patients

Summary

Introduction

Snake bite is a common and very important health problem in many parts of the world including our country [1, 2]. Different protocols exist to manage snake bite, some of the very commonly used ones of which are the protocols suggested by the World Health Organization (WHO), Goldfrank’s Toxicologic Emergencies (GF) textbook (Figure 1), and Haddad and Winchester’s (Haddad) Clinical Management of Poisoning and Drug Overdose textbook (Figure 2) [5,6,7]. These protocols are far different from each other regarding management of the patients and even in the determination of the severity of poisoning (Table 1) [6, 7]. No study has compared the efficacy of these protocols to determine the most efficient one with the least complications

Objectives

Methods

Results