1. Makunda Christian Leprosy and general Hospital
“Clinical study on snake bite syndrome, species correlation and ASV dose requirement”
Dr. Ann Miriam
Makunda Christian Leprosy and general Hospital
Bazaricherra P.O,
Karimganj Dist.,
Assam –
GPS coordinates:
24*25'55.78"N
92*19'51.33"E

2. Location
GPS coordinates:
24*25'55.78"N
92*19'51.33"E

3. Brief Hospital Statistics 2011-12 Total OP: 91,242 Total IP: 9471
Brief statistics of Karimganj District
Population: 12 Lakhs
Deaths due to snake bites : 0*
Oujha : 2
*According to NRHM data

4. Bazaricherra Gram panchayat
LOWAIRPOA BLOCK
Population : 1 Lakh
Bazaricherra Gram panchayat
Population : 12 thousand
A survey was done and it was noticed that there were only 2 deaths by snake bites in the last 15 years.

5. Common Poisonous snakes in Makunda
Red-necked keelback
Rhabdophis subminiatus
Banded krait
Bungarus fasciatus

6. Other venomous snakes identified by the local people
White lipped pit-viper
Greater black Krait
Monocled Cobra

7. Oujha

8. Probable cause of Cellulitis
Treatment by Oujha – Cutting of snake bitten area by using a blade and applying local herbal medicine

9. Dead snakes brought – Nil
Snake bites last year = 10
Venomous bites = 1
Non – venomous bites = 9
Mainly Hemotoxic = 1
Dead snakes brought – Nil

10. Patients requiring mechanical ventilation – Nil
OUTCOMES
Patients requiring mechanical ventilation – Nil
Patients requiring hemodialysis – Nil
Deaths - Nil

11. Whole blood transfusion
FACILITIES AVAILABLE
Bleeding time
Clotting time
Whole blood transfusion
Hemodialysis facilities – Machine available (Not in use)
Mechanical ventilators – yes
High Dependency area

12. Blood investigations done
Hemogram
Serum Creatinine
Blood Sugar
BT / CT
Platelet count
ECG

13. INDICATION FOR ASV ADMINISTRATION Prolonged BT/ CT
Adrenaline given when there is sign of anaphylaxis
Initial dose of ASV 8 – 10 vials
Duration of administration 4 – 6 hours
Test used for monitoring response -
Whole Blood Clotting Time
Time of measurement of coagulation parameters –
3 times in a day

14. ADMINISTRATION OF REPEAT DOSE OF ASV Not given so far
ADMINISTRATION OF CONTINUOUS LOW DOSE OF ASV

15. CEILING DOSE No experience USE OF NEOSTIGMINE

16. INDICATION FOR ANTIBIOTIC THERAPY Cellulitis COMMON ANTIBIOTICS USED
Ampicillin and Ampicloxacillin

17. PATIENTS ADMITTED IN
High Dependency area
PATIENTS REFERRED FOR
No referrals so far

18. COMPANY OF ASV PURCHASE Haffkine STOCK OF ASV 10 Vials

19. Why are snake bites so un-common in Makunda?
Thickly populated location
Venomous snakes present
Dense forests
Frequent floods

20. THANK YOU