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Study of Snake bite

Rangpur Medical College Hospital, Rangpur


Name of the Patient: Age: Occupation: Bed no: Reg no: Date & time of admission: Date & time of discharge: Date & time of biting: Interval between biting and appearance of Symptom: Duration of hospital stay:

Address:
Vill: Thana: Mobile no: Post: Dist:

Symptoms:
Site of bite: Activities during biting: Place of occurrence: First aid taken (type): Pain at the biting area: Swelling at the biting area: Bleeding at the biting area: Sleepiness: Yes Diplopia: Yes Dysphagia: Yes Nasal regurgitation: Yes Breathlessness: Yes Unconsciousness: Yes

No No No No No No

Examination findings:
Pulse: Cyanosis: Yes BP: Respiratory rate: No

Features of Neurotoxicity:
Ptosis: Present Opthalmophlegia: Present Open the mouth: Yes Swallowing: Yes Coughing: Yes Gripping: Yes Respiratory movement: Present Absent Absent No No No No Absent Absent

Features of envenomation: Present Information regarding the snake:


Did you see the snake: Yes If yes what is the local name of the snake: No

Treatment given at the hospital:


Antivenom: TT: Neostigmine: Intubation: Side effects of Antivenom: Antibiotic: TIG: Atropine:

Out come:
Recover: Death: Cause of death:

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