Bite-to-needle Time - An Extrapolative Indicator of Repercussion in Patients with Snakebite

Snakebite is a significant occupational and environmental hazard in tropical countries. The treatment of snakebite includes care of the wound, supportive care, and administration of anti-snake venom (ASV). Time is crucial to reducing the morbidity and mortality of patients. This study aimed to assess the "bite-to-needle time" with morbidity and mortality of snakebites and correlate it.

A total of 100 patients were included. Detailed history included the time since snakebite, bite site, species of snake, and symptoms at presentation, which included level of consciousness, cellulitis, ptosis, respiratory failure, oliguria, and bleeding manifestations. "Bite-to-needle time" was noted. Polyvalent ASV was administered in all patients. Duration of hospitalization and complications, including mortality were noted.

The age-group of the study population was 20-60 years. About 68% were males. Krait was the commonest species (40%), and the lower limb was the commonest bite site. Within 6 hours, 36% of patients received ASV, and between 6 and 12 hours, 30%. Patients with a bite-to-needle time of under 6 hours spent less time in the hospital and experienced fewer complications. Patients with bite-to-needle times longer than 24 hours had more ASV vials, complications, hospital-stay length, and death.

An increase in bite-to-needle time increases the chances of systemic envenomation, hence, the severity of complications or morbidity and risk of mortality increases. The necessity of timing and the value of administering ASV on time must be emphasized to the patients.

Jayaraman T, Dhanasinghu R, Kuppusamy S, Gaur A, Sakthivadivel V. Bite-to-needle Time - An Extrapolative Indicator of Repercussion in Patients with Snakebite. Indian J Crit Care Med 2022;26(11):1175-1178.