Journal of Health and Medical Sciences

ISSN 2622-7258

Published: 18 August 2020

Case Report: Management of Respiratory Failure Following Snake Bite

Mira Rellytania Sabirin, Reza Widianto Sudjud, Suwarman, Erwin Pradian

Soreang General Hospital (Indonesia), Universitas Padjajaran (Indonesia)

pdf download

Download Full-Text Pdf

10.31014/aior.1994.03.03.129

Pages: 338-349

Keywords: Anti Snake Venom, Neurotoxic, Respiratory Failure, Snake Bite

Abstract

Venomous snakebite cases are life-threatening medical emergencies. Most deaths were caused by respiratory failure due to acute neuromuscular paralysis. In this case, a man, 17 years old, was treated for snakebite on his upper arm one-hour prior hospital admission. Snakes was identified as cobras. Patient experienced symptoms of vomiting, seizures, headaches, weakness in the extremities and decreased consciousness. Local examination revealed two deep teeth marks. No hemorrhagic and myotonic manifestations were found. He then experienced respiratory failure, intubated and treated in the intensive care unit. Management of respiratory failure due to neurotoxic snake bites, namely administration of snake antivenom to bind poison, anti-cholinesterase and atrophine sulfate to release toxins from neuromuscular. Supportive therapy included ventilators, fluids, nutrition, tetanus toxoid, antibiotics. Fasciotomy was done on the bite wound because compartement syndrome was found. This patient did not show other abnormal manifestations because patient was promptly taken to the hospital. On day 3 hospital stay, he showed improvement, on day 6, he was moved to the ward. To achieve optimal results in cases of venomous snake bites, early diagnosis, early transportation to hospital and adequate management of snakebite were needed.

References

  1. Agrawal, P. N., Aggarwal, A. N., Gupta, D., Behera, D.,  Prabhakar, S., & Jindal , S. K. (2001). Management of Respiratory Failure  in Severe Neuroparalytic Snake Envenomation. Neurology India, 49(1),  25-8.

  2. Anil, A., Singh, S., Bhalla, A.,  Sharma, N., Agarwal, R., & Simpson, I. (2010). Role of Neostigmine and  Polyvalent Antivenom in Indian Common Krait (Bungarus Caeruleus) bite. Journal  of Infection and Publich Health, 3, 83 -87.

  3. Djunaedi, D. (2009). Penatalaksanaan  Gigitan Ular Berbisa. In A. W. Sudoyo, B. Setiohadi, I. Alwi, M. K.  Simdibrata, & S. Setiadi, Buku Ajar Ilmu Penyakit Dalam (5 ed., p.  280). Jakarta: Interna Publishing.

  4. Hifumi, T., Sakai, A., Kondo, Y.,  Morine, N., Ato, M., Shibayama, K., . . . Kuroda, Y. (2015). Venomous Snake  Bites: Clinical Diagnosis and Treatment. Journal of Intensive Care, 3(16).

  5. Kakaria, A., Narkhede, M., Agrawal,  S., Bhavsar, A., & Nukte, V. (2014). A Study of Outcome of Neuroparalytic  Snake Bite Patients Treated with FIxed Dose Antisnake Venom. International  Jounal Research in Medial Science (IJRMS), 4(2), 1676-82.

  6. Kasturirane, A., Wickermasinghe, A.,  de Silva, N., Gunawardena, N., Pathmeswara, A., Premaratna, R., . . . de  Silva, H. (2008). The Global Burden of Snakebita: A Literature Analysis and  Modelling Based on Regional Estimates of Envenoming and Deaths. PLoS  Medicine, 5(11), e218.

  7. kasturiratne, A., Wickremasinghe, A.  R., de Silva, N., Premaratna, R., Savioli, L., Lalloo, D., . . . Pathmeswaran,  A. (2008, 11). The Global Burden of Snake Bite: A Literautre Analysis and Modelling  Based on Regional Estomates of Envenoming and Deaths. PLoS Medicine, 5(11),  e218.

  8. Niasari, N., & Latief, A.  (2003). Gigitan Ular Berbisa. Sari Pediatri, 5(3), 92-93.

  9. Ranakawa, U., Lalloo, D., & de  Silva, H. (2013). Neurotoxicity in Snakebite: The Limits of Our Knowledge. PLoS  Neglected Tropial DIsease, 7(10), e2302.

  10. Sanmuganathan, P. S. (1998).  Myasthenic Syndrome of Snake Envenomation: A Clinical and Neurophysiological  Study. Postgrade Med J, 74, 596 - 599.

  11. Warrell, D. (2010). Guidelines  for the Clinical Management of Snake Bites in the South-East Asian Region. Thailand: World Health Organization. Regional Center for Tropical MEdicine,  Faculty of Tropical Medicine, Mahidol University.

  12. WHO. (2010). Guidelines for The  Production Control adn Regulation of Snake Antivenom Immunglobulin. Geneva: World Health Organization. Retrieved from  https://www.who.int/bloodproducts/snake_antivenoms/en/

About Us

The Asian Institute of Research is an online and open-access platform to publish recent research and articles of scholars worldwide. Founded in 2018 and based in Indonesia, the Institute serves as a platform for academics, educators, scholars, and students from Asia and around the world, to connect with one another. The Institute disseminates research that is proven or predicted to be of significant influence for the general public.

Stay Connected

  • Instagram - Black Circle
  • Facebook - Black Circle
  • LinkedIn - Black Circle

Contact Us

Please send all inquiries to the email:

editorial@asianinstituteofresearch.org

Business Address:

5th Floor, Kavling 507, Fajar Graha Pena Tower, Jl. Urip Sumohardjo No.20, Makassar, Indonesia 90234

Copyright © 2018 The Asian Institute of Research. All rights reserved