Shatabdi Giri
IMS & SUM Hospital, India
Title: Snake bite-A neglected menace: A prospective observational study in a tertiary care paediatric ICU
Biography
Biography: Shatabdi Giri
Abstract
Snake envenomation is a well-known cause of morbidity and mortality in India. In 2009, WHO declared snake bite a neglected disease. The objective of my study was to study clinical profile, complications and outcome in pediatric cases of snake bite and to highlight the atypical presentations of snake bite. A prospective observational study was done in PICU of our Hospital from June 2017 to June 2019 and the results were:-56.8% of 109 cases were non-poisonous snake-bites. Out of 47 cases admitted to PICU,68.08% developed cellulitis at the site of bite with staphyloccoccus aureus being the commonest organism isolated(56.25%). Edema at site of bite(hematotoxic) and ptosis(neurotoxic) were most common initial presentation. 36.17% of patients received ASV and first aid within 6 hours of snake bite. The morbidity and mortality was significantly less(p<0.05) as compared to those who hadn’t received ASV. 12.76% of cases with normal CRT presented with features of coagulopathy. DIC(58.33% of hematotoxic bites) and respiratory paralysis(68.75% of neurotoxic bites) were the commonest complications. Renal replacement therapy was required in 6.38%, transfusion in 10.63% cases and case-fatality-rate was 12.7%. There were a few atypical presentations of snake bite mimicking Gullain-Barre-Syndrome , acute onset encephalitis, intracerebral hemorrhage and cortical blindness. The conclusion of my study was:- Most snake bites are non-poisonous. Early first aid and ASV administration has better outcome. Fibrinogen levels are more reliable than CRT to diagnose coagulopathy. Acute onset of atypical presentation should always be evaluated for snake envenomation in suspected cases to prevent morbidity and mortality.(249 words).