Do's and Don't of Snake Bite

Courtesy : Times of India : Bitten by a snake? Avoid tying a cloth above the wound or sucking out the infected blood.

Experts, who have now formulated the country's first national snake bite management protocol, say these measures, usually thought to be the most effective, are actually myths.

India records the highest snake-bite mortality rate in the world. WHO estimates that 2.5 lakh people are bitten every year, among whom 50,000 die. Those who survive the bite for a brief period still die subsequently due to delay in medical intervention, unable to reach a hospital within the crucial golden hour, or due to lack of treatment protocols, resulting in overdose of anti-venom.

Finally waking up, the health ministry has finalized the protocol to provide doctors and common man with the best approach to deal with snake bite emergencies. The document, which is available with TOI, says the majority of current first aid methods adopted by victims such as tourniquets, cutting and suction are completely ineffective and dangerous.

The ministry has, therefore, asked doctors to adopt the "Do it Right" approach, stressing the need for reassurance, immobilisation, getting to hospital without delay and telling the doctor of any symptoms that develop. At present, inappropriate administration of anti-snake venom (ASV) when it is not required and/or in doses well in excess of the required amount, is the cause of tremendous worry.

The protocol, therefore, species how a diagnosis should be carried out and ASV injected. "The 20-minute Whole Blood Clotting Test (WBCT) should be conducted. The recommended initial dose of ASV should be 8-10 vials over an hour," the protocol says. It says handling of ASV reactions is very straight forward if dealt with early.

"No ASV test doses are to be administered. Prophylactic regimens of steroids have no valid trial evidence to support them. At the first sign of an adverse reaction, ASV should be halted." Officials say that despite the fact that the neostigmine test was actually an Indian discovery, it is still poorly used in the country.

"Neostigmine test should be carried out in all neurotoxic bites," officials say. The document adds: "The new protocol has shown very positive results where it has been implemented (West Bengal and Kerala). Increased doctor confidence in managing snake-bite has been recorded and mortality has reduced."

An official said: "We have sent the protocol to the states who have been asked to create a separate budget under National Rural Health Mission to deal with snake bites. Workshops are being conducted to train doctors on the protocol."

India is home to 13 snake varieties which are highly poisonous