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Janet Jacob*, Sharon Sunil, Teena Nazeem and Rajeswari Ramasamy


Snakebites are reported virtually from every part of the world and remains life-threatening injuries, sometimes requiring intensive care. Snakebites are estimated to cause approximately 100,000 deaths each year worldwide, among which India is being estimated to have the highest snakebite mortality in the world. There are about 236 species of snakes in India, most of which, there are 13 known species that are poisonous and of these four, namely common cobra (Naja naja), Russell’s viper (Dabiola russelii), saw-scaled viper (Echis carinatus) and common krait (Bungarus caeruleus) are highly venomous and believed to be responsible for most of the poisonous bites in India. Most of the fatalities are due to the victim not reaching the hospital in time where definite treatment can be administered. Snake venoms may produce local tissue damage and/or distinct clinical syndromes, including neurotoxicity, coagulopathy, hypotension, rhabdomyolysis and renal failure. Twenty-minute whole blood clotting test (20WBCT) is considered as reliable test of coagulation for diagnosis Pain can be relieved by oral Paracetamol or Tramadol. Anti-Snake Venom (ASV) is the mainstay of treatment and should be administered only when there are definite signs of envenomation, i.e. coagulopathy or neurotoxicity. In India, polyvalent ASV, i.e. effective against all the four common species; Russell’s viper, common cobra, common Krait and saw-scaled viper and no monovalent ASVs are available. The paper reviews current literatures on the epidemiology, clinical manifestation, diagnosis and treatment of snake bites with an aim to help health care providers a better understanding of clinical management of bites.

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