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Posted by Sushant Wagley, as told to him by Dr. Jhapat Thapa

This evening, a six-year old boy was brought to Bayalpata Hospital after being bitten by a snake on his right leg. The patient, his father, and another relative walked for 3 hours to reach our hospital for treatment. He was our first overnight emergency patient since we opened the hospital with outpatient, emergency, and delivery services four days earlier.

While snakes are common in this area of Nepal, most are not poisonous. However, they are also greatly feared because the ones that are poisonous can kill quite rapidly. Our patient’s relatives were quite nervous about the bite because of the narrow window of treatment time if the bite were poisonous.

Upon the family’s arrival, we admitted the child as an emergency patient. We then administered an IV to stabilize him and gave him a tetanus injection to prevent infection. We wrapped his leg with a bandage to reduce movement of his injured leg. Due to the uncertainty of whether the snake venom was poisonous, the child stayed at our hospital overnight for observation. We monitored him carefully – if his vital signs deteriorated, we would quickly administer the anti-venom treatment. His father, alongside Nyaya health providers, tended to the boy throughout the night. Fortunately, he was discharged after a final examination that deemed him healthy.

Kamala Sharma, one of our auxilliary nurse midwives, treating the patient.

Kamala Sharma, one of our auxilliary nurse midwives, treating the patient.

This six-year old is not the first snake bite patient that Nyaya has treated. A past case involved an elderly woman who was bitten by a poisonous snake. Her family brought her to our Sanfe Bagar clinic after a four-hour walk. However, she was not as fortunate as the six-year-old boy and unfortunately passed away at the clinic during the night.

Since poisonous snake bites can kill within a few hours, the large distances patients need to travel to reach an appropriately equipped health facility can be deadly. Nyaya Health is one of the only providers of anti-venom in the district of Achham. Thus, patients who live more than 3-4 hours from our site are likely to die from fatal snake bites. One of the best ways to reduce such deaths is to properly equip government sub-health posts with anti-venom and training on how to properly treat all types of snake bites.

2 Responses to “Treating a potentially deadly snake bite”

  1. Dr. Manohar Joahi, MD says:

    Snakes in the hills are not safe all the time. Certain species in the hills or snakes transported there from terrain via vehicles are not impossible. Mast of the snake bites at hills are locally poisonous. So local site whwre the part was bitten should take care.

    There is temendous psychological fear of death after snake bite. So many may go into vago-vasal attacks. Symptomatic and supportive treatment of the patient may be sufficient.

    Patient with the symptoms and signs of snake bites should be treated with anti-snake venom injections. But the anti-snake venum serum available at Nepal are only effective for Kraits, cobra and 2 species of vipers. Next species in the mountaims may not be effective with this anti-snake venom. Supportive management of the case counts a lot. Thanks for your hilarious effort to save the life of Nepalese.

  2. Thank you Dr.Joshi,

    Good to hear from you,

    Yes indeed, the sheer fear itself and the widespread speculations regarding the snakebite itself is vague, esp in area like Achham where we work. We indeed need to do species identification before we administer the anti-venom.
    Supportive care is essential in cases and situations like ours.

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