Snakebite Management Concerns

Many issues may arise in the treatment of a patient who suffers from a snakebite.

It is well-known that the occurrence of snakebite can lead to a variety of biochemical and pathophysiologic abnormalities. These may include coagulation disturbances which result from the injection of snake venom into the victim. Some suggest, therefore, that the physician administer fresh frozen plasma, fresh whole blood, cryoprecipitates, or platelet concentrates to reverse the situation.

Coagulation Management Precautions

Though these approaches are reasonable in some instances, one must remember that in developing countries the screening of blood products is not as efficient as in the United States. Hence, blood transfusions or the use of other blood products may place the patient at risk for the acquisition of bloodborne infections such as human immunodeficiency virus, viral hepatitis, or human T-cell leukemia virus.

In light of the coagulation problems that do occur in some snakebite victims, the health care team should not prescribe heparin or antifibrinolytic agents to the patient.

Snake Venom Ophthalmia

In Africa, snakebite may lead to eye problems such as conjunctivitis, bullous corneal erosions with secondary infection, anterior uveitis, corneal opacities, and permanent blindness. These presentations can result from the bite of certain elapid snake species. However, it is possible to manage this condition and prevent some of its consequences (World Health Organization 2010).

The first measure is to irrigate the eyes with copious amounts of water. Milk is a suitable alternative for this as well. It is easier to flush the eyes when the physician administers local anesthetic eye drops than without any anesthesia.

Ophthalmoscopic examination of the eyes is, of course, necessary, and the doctor will search for corneal abrasions with fluorescein stain or slit-lamp evaluation. Should abrasions of the cornea be present, topical antibiotic eye preparations which contain either tetracycline or chloramphenicol are generally effective therapies.

To address the sensation that eyes are burning, one-tenth percent adrenaline eye drops or ten percent phenylephrine ophthalmic solution is beneficial. Nevertheless, these agents exert a sympathomimetic effect on the human body, and one must use them with caution in elderly patients or anyone else in whom rapid heart rate or blood pressure elevation poses a problem.