CANNING SUBDIVISIONAL CANNING SUBDIVISIONAL HOSPITALHOSPITAL

24-PARAGANAS( S), W.B.24-PARAGANAS( S), W.B.

Dr. Dayal Bandhu MajumdarDr. Dayal Bandhu Majumdarwww.kalachkrait.webs.comwww.kalachkrait.webs.com

Number of snake bites in 2012.Number of snake bites in 2012.

Total Number : 1225.Total Number : 1225.

Non Venomous Bites : 1157.Non Venomous Bites : 1157.

Venomous Bites : 68.Venomous Bites : 68.

Neurotoxic Bites : 65.Neurotoxic Bites : 65.

Hemotoxic Bites: 3.Hemotoxic Bites: 3.

Number of Deaths : 10.Number of Deaths : 10.

TREATMENT PROTOCOLTREATMENT PROTOCOL

Status of the HOSPITALStatus of the HOSPITAL

22ndnd tier Govt. Hospital. tier Govt. Hospital.

Number of M.Os: 22.Number of M.Os: 22.

All the M.Os are treating S.Bite All the M.Os are treating S.Bite Cases.Cases.

No ICU or ITU.No ICU or ITU.

No Mechanical Ventilator.No Mechanical Ventilator.

No Dialysis unit. No Dialysis unit.

Blood Bank for Whole Blood only.Blood Bank for Whole Blood only.

No. Laboratory for 24 hrs No. Laboratory for 24 hrs coveragecoverage..

TREATMENT POLICYTREATMENT POLICY

By Syndromic approach only.By Syndromic approach only.

Snakes brought to Hospital: 30 Snakes brought to Hospital: 30 only ( out of 1225 bites).only ( out of 1225 bites).

Vast individual variation on ASV Vast individual variation on ASV Dosage.Dosage.

Transferred to Kolkata for Transferred to Kolkata for Mechanical Ventilation only.Mechanical Ventilation only.

10 patients died before transfer.10 patients died before transfer.

Cause of DeathsCause of DeathsTotal Deaths ( in 2012) : 10.Total Deaths ( in 2012) : 10.

Respiratory failure in all cases.Respiratory failure in all cases.

7 due to terminal stage reporting.7 due to terminal stage reporting.

3 ( ? ) Due to ASV failure; all Krait 3 ( ? ) Due to ASV failure; all Krait bites.bites.

ASV Brand USEDASV Brand USED

Free Supply from State Govt. Free Supply from State Govt. Central Store.Central Store.

Manufacturers :Manufacturers :

1)1)Biological E.Biological E.

2)2)VINS.VINS.

3)3)Bharat Serum.Bharat Serum.

ASV REACTIONASV REACTION

Reaction in 3 cases only ( in 68).Reaction in 3 cases only ( in 68).

No Death from Reaction.No Death from Reaction.

One Bronchospasm.One Bronchospasm.

Two Urticarial Rashes .Two Urticarial Rashes .

Preventive Adrenaline not used.Preventive Adrenaline not used.

Reaction Managed without Inj. Adrenaline.Reaction Managed without Inj. Adrenaline.

AREA COVEREDAREA COVERED8 Blocks of the Sunderban Area.8 Blocks of the Sunderban Area.

Population covered : 2 Million.Population covered : 2 Million.

Mostly Primary cases.Mostly Primary cases.

Referred cases from Primary Health Referred cases from Primary Health Centers also. Centers also.

Door to Door Survey revealed 23% Door to Door Survey revealed 23% Hospital attendance only. Hospital attendance only.

COMMON KRAITCOMMON KRAIT

Mysterious C. KraitMysterious C. Krait

80% of the Venomous S. Bites.80% of the Venomous S. Bites.

100% in the 100% in the Floor Bed Floor Bed ( in Night).( in Night).

95% Presented with Pain Abdomen.95% Presented with Pain Abdomen.

Other Symptoms: Vomiting, fainting Other Symptoms: Vomiting, fainting Attack, Arthalgia. Hemiperesis or Attack, Arthalgia. Hemiperesis or quadriperesis.quadriperesis.

No H/O Bite in many cases.No H/O Bite in many cases.

All had All had Bilateral ptosisBilateral ptosis in different times. in different times.

Exceptions Exceptions

Very few Russell’s Viper in the areaVery few Russell’s Viper in the area..

No Spectale Cobra ( No Spectale Cobra ( Naja NajaNaja Naja).).

All Cobras are Naja Kauthia.All Cobras are Naja Kauthia.

Plenty of Common Kraits(Plenty of Common Kraits(Bungarus Bungarus caeruleus).caeruleus).

No Banded Krait ( No Banded Krait ( Bungarus Fasciatus).Bungarus Fasciatus).

No Sawscled Vipers.No Sawscled Vipers.

GREEN PIT VIPERSGREEN PIT VIPERS

Present only in the islands of Sunderbans.Present only in the islands of Sunderbans.

Practically non-venomous.Practically non-venomous.

Causes local swellings only.Causes local swellings only.

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