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Name: Dr.. Prashant Vaidya, Dr. Hemant Ramavat, Dr.

Dinesh Vaidya Address: Rural Toxicological Centre, Vaidya Hospital, DUNGRI 396375, W.Rly., Gujarat. E.mail : Contact N.o. M. 09825053231 Res. Office:

Name of Institution : Rural Toxicological Centre, Dungri, Valsad Title: CRITICAL CARE OF SNAKE BITE POISONING Objectives: Main aim of this presentation on snake bite poisoning is to emphasize that snake bite can be managed in any area with a very high survival rate. Medical collages & clinical physicians must give enough importance to the management of snake bites. Material & Methods: The paper reflects an experience of study of 18,821 cases of snake bite poisoning admitted at Rural Toxicological Centre, at Vaidya Hospital, Dungri, in south Gujarat. Differentiation of poisonous and non poisonous snake bites was carried out through sign & symptoms, particularly from fang marks. The patients with poisonous snake bites were admitted in critical care unit for close clinical observations and treated according to the type of snakes i.e. Cobra, Common Krait, White banded Krait, Viper & Echis Craniata. While non-poisonous snake bite cases were almost discharged on the same day after first aid treatment and councelling. Different doses of ASV and complications of cardiac, respiratory and acute renal failures in different types of snakebites and mandatory investigations are discussed in detail. Results: Out of 18,821 snake bites only 3,431 (18 %) snake bites were poisonous, while 15,390 (82%) were non poisonous. Death rate has reduced to only 2.2 per 1000 snake bites due to adequate dose of ASV and advance management of critical care with respiratory support, cardiac monitoring and haemodialysis. Conclusions: In case snake bite poisoning following points are very important: Early Transport is most vital. Differentiation between poisonous and non poisonous snake bites. Very few equipment are required. ARF needs peritoneal Dialysis. High dose of ASV & Respiratory support in Cobra & Krait bites is life saving. In Krait & viper bite force diuresis has prevented renal complications in patients. In Cobra bite, local ASV at the site of bite has prevented tissue necrosis in 70 % of cases.