CLINICAL FEATURES IN SNAKE BITE

Jang, In Sung; Lee, Jong An; Kim, Seung Yul; Hyun, Seok Chun; Park, Sang Mun; Park, Jun Seok; Kim, Gab Teug; Song, Hwa Sik

J Korean Soc Emerg Med > Volume 7(4); 1996 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 1996;7(4): 580-589.

CLINICAL FEATURES IN SNAKE BITE

In Sung Jang, Jong An Lee, Seung Yul Kim, Seok Chun Hyun, Sang Mun Park, Jun Seok Park, Gab Teug Kim, Hwa Sik Song

Department of Emergency Medicine, College of Medicine, Dankuk University, Chunan, Korea

Published online: December 31, 1996.

ABSTRACT

To evaluate the efficacy of antivenin in the evenous snakebite patients, we analyzed the 100 cases with evenous snakebite who was from the Chunan and rural areas around the city. The data was obtained from the three major hospitals in the Chunan from 1995. 1. 1. to 1996. 6. 30. The injury of the evenous snakebite was commonly occurred in male, hot weather(June & August), and daytime. The majority of the snakebites were encountered in the exposed body surface areas, such as fingers, hands, feet and ankle. We treated the patients with antivenin in 60 cases, local incision & suction in 30 cases, and combination of antivenin and incision in 10 cases. The initial dosage of the antivenin was based on the severity of evenomation. We did not use the antivenin in 3 cases of grade 0. Forty-seven cases in grade I were treated with an intravenous infusion of 1-3 vials (mean : 0.85vials) of antivenin(Biken) given within 12 hours after the bite, thirty-seven cases in grade II with 1-5vials(mean:1.1vials), and thirteen cases in grade Ⅲ. with 5-15vials(mean:9.2vials). Local necrosis around the site of snakebite and anemia(Hb<10) were occurred in 9 patients with use of antivenin and in 4 patients without use of antivenin in grade II, and in 2 patients with use of antivenin in grade Ⅲ. Three patients in grade ill had early major complications including acute renal failure, pulmonary edema, and sepsis. Two out of three patients with major complications were not treated with antivenin. One case in grade II without use of antivenin lost her fetus in 26th week. The deaths due to evenous snakebite was zero. We conclude that the patients with evenomation should be treated with an intravenous infusion of antivenin in 1st 6-8hour after snakebite to lessen the complication and mortality.

Key words: Snakebite, Antivenin, Complication