Medical management – ward

Medical management – Ward management

After 1-3 hours after bite:

  • paralysis of cranialnreves
  • haemorrage from mucosal surfaces
  • hypotension
  • tachycardia
  • dysphonia
  • dysphagia

After 3 hours after bite:

  • paralysis of truncal, limb and respiratory muscles
  • peripheral circulatory failure
  • hypoxaemia
  • haemolysis
  • rhabdomyolysis (uncommon in most Aus snakes)

 

Secondary Treatment in hospital :

  • Snake bite victims will be observed closely in hospital
  • Management includes local wound / limb care and supportive treatment
  • Supportive treatment includes pain relief, treatment of possible secondary infection, blood/ blood coagulation factors transfusion, assisting breathing and so on
  • Depending on the severity of the bite the doctor will administer specific antivenom
  • Tetanus immunization/booster is also necessary 
  • Certain ongoing symptoms are treated symptomatically whilst others rely on antivenom effectiveness.

 

Investigations

1. Bite site – for snake identification and secondary infection prevention/treatment

2. Urine test – test for venom, blood and proteins to detect internal damages

3. Blood and Serum – coagulation tests, blood groups in case transfusion required, blood gases monitored in case of respiratory failure

4. Electrocardiogram – monitoring important for renal failure, myocardial ischaemia , hypotension etc.

5. Pulse oximetry – monitor gas exchange and warn of respiratory failure.

 

Monitoring and Management

1. Coagulation factors and blood transfusion

Coagulation factors are required if haemorrhage is present.

2. Intravenous fluids, rhabdomyolysis and renal protection

After acute resuscitation, intravenous fluids should be administered.

3. Analgesia and sedation

To reduce pain.

4. Care of the bite site

Usually no specific care other than routine wound care is required.

5. Other drugs

Antibiotics are not routinely required but should be given if the wound appears infected.

 

OVERALL: most of the lingering effects of the snake bite are treated by antivenom and symptomatic management 

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~ by pcl4 on July 24, 2008.

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