Original articles

Severe Snakebites in Northern KwaZulu Natal: Treatment Modalities and Outcomes

Darryl Wood, Caroline Webb, Jenine DeMeyer

Abstract


Objective
We aimed to study the outcomes of severe snakebites in patients admitted to Ngwelezana Hospital in North East KwaZulu Natal, seasonal variations, and the effectiveness and complications of antivenom.

Design
A prospective observational outcomes study was conducted over a one-year period (1 June 2007 to 31 May 2008). The study group was from the north-eastern KwaZulu Natal region of South Africa, with a population of approximately 3 million people and included all patients bitten by snakes and admitted to the Ngwelezana Hospital Emergency Medicine Unit (EMU). Departmental practice guidelines were documented and followed.

Outcome measures
End points for patient outcomes included, transfer from the EMU to the ward, discharge home from the Emergency Medicine Unit, follow-up of patients’ outcomes who required surgery or ICU care

Results
243 snakebite patients were recorded. The highest incidence was the summer months; 46 (18.93%) experienced one or more severe complication; 29 (11.93%) received some type of definitive management in hospital; 22 (9.05%) of these patients received antivenom. Antivenom was administered to more children than adults. Adverse reactions to antivenom were common; an allergic response occurred in 4 (15.4%), anaphylaxis in 6 (23.1%) cases; the highest incidence occurred in the 0-10 year age group. No deaths were recorded.

Conclusions
Snakebites are common in the summer months in Northeast KwaZulu Natal. Children are particularly vulnerable to snakebites and the effects of anti-venom. Adverse reactions to antivenom are common. The management of severe snakebites that require antivenom should be in the hospital setting with advanced airway support. The syndromic approach to treatment is simple and effective to use.

Authors' affiliations

Darryl Wood,

Caroline Webb,

Jenine DeMeyer,

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Keywords

Snakebites; Antivenom; Anaphylaxis; Envenomation; Compartment syndrome; Swelling; Coagulation

Cite this article

South African Medical Journal 2009;99(11):814.

Article History

Date submitted: 2009-01-15
Date published: 2009-11-05

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