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An epidemiological and clinical study of snake-bites in childhood
1Royal Children's Hospital, Herston.
Insights
This 10-year study of pediatric snake-bites in Queensland found that while most children recovered without fatalities, appropriate first aid was rarely administered. The study highlights the need for improved snake-bite management and first-aid education for children.
Area of Science:
- Pediatric Emergency Medicine
- Toxicology
- Clinical Research
Background:
- Recent advancements in elapid snake-bite first-aid and venom-detection kits have emerged.
- A 10-year retrospective study was conducted on pediatric snake-bite admissions in southeast Queensland.
Purpose of the Study:
- To analyze the clinical characteristics and outcomes of snake-bite incidents in children.
- To evaluate the effectiveness of current first-aid practices and diagnostic tools in pediatric snake-bite cases.
Main Methods:
- A review of 218 consecutive pediatric hospital admissions for confirmed or suspected snake-bites over a decade.
- Data collected included patient demographics, bite location, clinical manifestations, snake identification, first-aid practices, and treatment administered.
Main Results:
- Preschoolers were a significant victim group, with prepubescent boys at the highest risk. Most bites occurred on lower limbs.
- 42% of admitted children showed symptoms consistent with snake-bite. Snake genus identification was achieved in 18.8% of cases.
- Appropriate field first aid was documented in only 18% of cases. Antivenom was given to 14 children, with one severe anaphylactic reaction. No fatalities or permanent morbidity were reported.
Conclusions:
- Pediatric snake-bites in this region, despite challenges in first aid and diagnosis, generally have favorable outcomes.
- The findings underscore the critical need for enhanced public education on snake-bite first aid and improved diagnostic capabilities in clinical practice.
Abstract:
The last decade has seen major changes in the first-aid management of elapid snake-bites and the introduction of a new venom-detection kit which can identify the genus of medically-important snakes. In the light of these developments, we report a 10-year study that comprised 218 consecutive children who were admitted to hospital in southeast Queensland, after a confirmed or a suspected snake-bite. One-third (34.9%) of victims were preschool children (zero to five years of age) but the highest "at-risk" group comprised prepubescent boys. In 70% of cases, the bite was on a single lower limb. Of the 218 children who were admitted to hospital, 42% manifested local or systemic symptoms that were consistent with a confirmed snake-bite, irrespective of whether or not the species of snake was venomous. A positive identification of the genus of the offending snake was established in 18.8% of cases. In 35.8% of cases, the Commonwealth Serum Laboratories' Venom Detection Kit was used in an attempt to identify the involved snake, with 10 (4.6% of all cases) positive test-results. We have found that appropriate first aid was applied in the field in a maximum of 18% of cases. Antivenom was administered to 14 children, seven of whom received polyvalent antivenom; one child manifested a severe anaphylactic reaction. There were no fatalities in this series, and no permanent morbidity.