Snake bites NAV JIVAN HOSPITAL TUMBAGARA, SATBARWA POST PALAMU DISTRICT, JHARKHAND.

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Presentation transcript:

Snake bites NAV JIVAN HOSPITAL TUMBAGARA, SATBARWA POST PALAMU DISTRICT, JHARKHAND

Where are we...

How to reach NJH... From Kolkota: 12 hours by train to DTO From Ranchi: 4 hours by road: 135 kilometers From Delhi: 12 hours by trains to DTO – rajdhani/garib rath Nearest rail-head: Daltonganj (DTO): 35 kilometers

HOW BUSY WE ARE (till 28 feb) GENERAL OP EYE OP ANTENATAL DENTAL INPATIENTS DELIVERIES CESARIAN

Snake Bites...

2012 (Jan-Dec) – Alleged snake ALLEGED SNAKE MALEFEMALETOTAL KRAIT COBRA 134 VIPER UNKNOWN OTHERS 2810 TOTAL

SYNDROMES DIAGNOSISMALEFEMALETOTAL NON VENOMOUS NEUROTOXIC HEMOTOXIC 8412 NEUROTOXIC AND HEMOTOXIC 101 ONLY LOCAL REACTION 9615 OTHERS 044

Snakes brought... 5 (out of 127) 4 alive ? ? ?

Mechanical Ventilation MALESFEMALESTOTAL NEUROTOXIC NEEDED MECHANICAL VENTILATION 9918

Haemodialysis All bites with deranged whole blood clotting time. Nearest dialysis centre – 135 kms away Transport facilities – safe only in daytime Extreme poverty

4 deaths AgeAlleged snakeSyndromeCause of death 16 UnknownHaemotoxic? Anaphylaxis 12 UnknownNeurotoxic? Anaphylaxis 72 KraitHemotoxic +NeurotoxicCardiac arrest on ventilator 40 ViperHemotoxic? Myocarditis

Facilities we have... Can do only clotting time. Anaesthesia ventilator No blood bank. But if donor is available, we have facilities to bleed the donor and donate it immediately.

When do we refer... We give all patients an option to go to higher centre. 135 kms away Poor road and transportation facilities Patients on respiratory arrest... No choice Viper bites... All efforts to refer

Issues of concern – unknown bites MALESFEMALESTOTAL NON VENOMOUS NEUROTOXIC 224 HEMOTOXIC 314 TOTAL UNKNOWN BITES