Abstract
Children bitten by venomous snakes comprise emergency cases that present high morbidity and mortality, especially in some regions of Asia and Africa. Reports on clinical features and management of envenomated children are scarce. This observational study implemented a protocol for antivenom use in pediatric snakebite victims in Taiwan, between 1994 and 2007. The present work investigated demographics, clinical features and effects of antivenom therapy and the complications and prognosis for snakebites. A total of 55 children and adolescents, with a median age of 9.9 years (ranging from 2 to 18 years), was identified. Forty-five patients (82%) were bitten between May and September. Thirty-five patients (64%) received antivenom therapy, 28 of them (80%) within two hours after being bitten. No fatalities occurred and only five of 35 patients (14%) had major morbidity when treated according to the protocol. Thirty-one snakes (56%) were identified and 12 of them (38%) were Naja atra. This study indicates that a protocol for children affected by snakebites is valuable for guiding emergency physicians to treat these patients immediately. Further strategies are required to reduce the morbidity rate that occurs as a result of Naja atra bite.
Highlights
Snakebite injuries are not uncommon in Asia [1,2,3,4]
This study indicates that a protocol for children affected by snakebites is valuable for guiding emergency physicians to treat these patients immediately
As the habitats of snake species often overlap with human environments, children are occasionally bitten by snakes [8]
Summary
Snakebite injuries are not uncommon in Asia [1,2,3,4] Reports of their clinical features and management in children are scarce, even in countries known to present a high snakebite incidence [5, 6]. Research into the management of venomous snakebites in children is crucial. A protocol for snakebite management had been applied to pediatric patients with snakebites in our institutes. We investigated the clinical features, antivenom management, complications and prognoses for snakebites in children. No antivenom was administered to these non-envenomated patients and outpatient follow-up was arranged. Complications and Prognosis Complications after snakebite were investigated and included respiratory failure, hemodynamic instability, systemic reaction after antivenom use and need for surgery. Functional impairment of the bitten limb during follow-up and mortality rate were addressed
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