• Users Online: 459
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Contacts Login 
ORIGINAL ARTICLE

Descriptive study of snakebite patients in Northern Taiwan: 2009 to 2016


1 Department of Emergency Medicine, National Defense Medical Center, Tri-Service General Hospital; Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan
2 Department of Emergency Medicine, Division of Clinical Toxicology, Taichung Veterans General Hospital, Taichung, Taiwan
3 Department of Emergency Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
4 Department of Internal Medicine, Division of Cardiology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
5 Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan
6 College of Life Sciences, National Tsing Hua University, Hsinchu, Taiwan

Correspondence Address:
Shih-Hung Tsai,
Department of Emergency Medicine, National Defense Medical Center, Tri-Service General Hospital, No. 325, Sec. 2, Cheng-Kung Road, Taipei
Taiwan
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmedsci.jmedsci_68_18

Background: Taiwan is located in a subtropical area where there are approximately 50 kinds of land snakes and six principal kinds of venous snakes. Snakebite envenomation is not an uncommon issue in Taiwan. We design a study to obtain an understanding of the characteristics of snakebites and snakebite patients in a medical center in northern Taiwan. Materials and Methods: This was a retrospective medical records study of an 8-year period. We used the key word “snake” to search the emergency department (ED) diagnosis of all patients and then used antivenom management codes to select patients for inclusion. The species of snake involved, time and site of the bite, geographic data of the patients and patient outcomes were recorded. Results: In total, there were 125 snakebite patients (male 70%, female 30%). The snakes involved were Protobothrops mucrosquamatus (50%), followed by Trimeresurus stejnegeri (7%). The feet and ankles were the most frequently bitten areas (42.4%). The peak months were July and October. The average ED stasis time was 2 hours and 45 minutes, and 65.6% of snakebite patients received antivenom. In patients bitten by P. mucrosquamatus, there was a high surgical rate, 23.8% higher than those reported in other studies. No mortalities or side effects of antivenom were reported in these patients. Conclusion: We propose a clinical flow chart for physicians who are treating patients bitten by P. mucrosquamatus. Snakebites, especially those inflicted by P. mucrosquamatus, induce severe soft tissue swelling, which can mimic compartment syndrome. Antivenom for P. mucrosquamatus is the first and only choice of treatment. The amount of antivenom needs to match the clinical symptoms. Patients bitten by P. mucrosquamatus may need longer observation times than patients bitten by other species of snakes, in addition to toxicologist consultations, sonographic examinations, and measurement of the objective compartment pressure before surgery.


 

  Search Pubmed for
 
    -  Ho CH
    -  Mao YC
    -  Tsai YD
    -  Lin CS
    -  Liu SH
    -  Chiang LC
    -  Hung Y
    -  Tsai SH
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed110    
    PDF Downloaded8    

Recommend this journal