O-6 Assessment of Pre-Hospital Measures on Outcomes in Snake Envenomation
Author(s):
CHatcher, NNguyen, SBidaisee
Year of Presentation:
2022
Objective: To determine the common risk behaviours and
circumstances associated with snakebite and determine if
pre-hospital measures had clinical relevance on the outcome
of envenomation.
Methods: Ethical approval was obtained from the Ministry of Health Ethics Committee. A cross-sectional study using data from snakebite cases was collected from the Eastern Regional Health Authority in Trinidad. Data collection involved reviewing patient records and interviewing the patients.
Results: Twenty-nine patients were admitted for envenomations during 2017–2019. Twenty-two were male and between 18–40 years old. Farmers accounted for 34.5% of the bites and 68.9% were bitten by the Mapepire Balsain. Of the bites 41.4% were occupational while 34.5% of bites were recreational. Pre-hospital measures included irrigation (10.3%), cutting (6.9%), tourniquets (44.8%), pressure immobilization (6.9%), topical applications (3.4%), and ingestion of a substance (6.9%). Hospital care was received within 1 hour of the bite in 34,5% of persons while 55.2% arrived at the hospital between 1-4 hours of being bitten. Hospital care was administered for local reactions (82.8%), coagulopathy (72.4%), compartment syndrome (17.2%), and cellulitis (3.4%). Treatments included vitamin K (13.8%), antibiotics (93.1%), and anti-venom (82.7%). Debridement was required in 10.3% of patients and 3.4% required a fasciotomy. The average stay in the hospital was 3.8 days.
Conclusion: Persons are most likely to be envenomated by the M. Balsain in Trinidad. These patients are commonly males ranging anywhere from 18–40 years presenting local reactions and coagulopathy needing admittance to the hospital.