EVALUATION OF SNAKE BITE-TO-NEEDLE TIME AND ITS RELATIONSHIP TO SNAKEBITE MORTALITY AND MORBIDITY

Abstract

Background: Snakebite is a major environmental and occupational hazard commonly observed in tropical countries.
Snakebite is treated with antivenomous, supportive care and wound care. Time is a critical factor in reducing snakebiterelated
mortality and morbidity.
Objective: The objective of this study was to evaluate the time from bite to needle and its correlation with mortality and
morbidity in snakebite subjects.
Methods: Detailed histories were recorded by 200 subjects, including snake bite symptoms, species of snake, location of
bite, and time after the snake bite, as well as signs of bleeding, oliguria, respiratory failure, ptosis, cellulitis and level of
consciousness. The time from bite to needle was also taken into account. All subjects were administered multivalent
snake antivenom. Associated mortality, complications and length of hospital stay were also noted.
Results: The most common snake species involved was the Krait, and the lower limb was the most commonly involved
site. ASV was administered to 72 subjects within 6 hours and 30% of subjects within 6-12 hours. Decreased length of
hospital stay and complications were observed in subjects with more deaths, length of hospital stay and complications
within 24 hours of needle tip, and use of an ASV vial.
Conclusion: Increased systemic envenoming is associated with bite-to-needle time, which further increases the risk of
mortality, morbidity and severity of complications. The value of ASV administration and the need for timing should be
emphasized in the worm bite.