24/10/2025
For the first time in Bangladesh, the Snake Bite and Toxicology Department has been launched at Rajshahi Medical College Hospital. Ward No. 58
Snake bite & it's management at a glance
immediate first aid, followed by rapid transport to a medical facility for professional evaluation and definitive care. The primary goal is to minimize venom spread, manage symptoms, and administer antivenom if necessary.
Do:
1)Move away from the snake: Ensure the patient and others are a safe distance from the snake to avoid a second bite.
2)Stay calm and still: Keep the patient calm and still. Anxiety can increase the heart rate and accelerate the spread of venom.
3)Immobilize the bitten limb: Place the limb in a neutral, comfortable position using a splint or bandage to restrict movement.
4)Remove constrictive items: Take off rings, watches, and tight clothing from the affected limb before swelling begins.
5)Clean the bite: Gently wash the bite with soap and water and cover it loosely with a clean, dry bandage.
6)Call for emergency help: Contact emergency services immediately to arrange transport to a hospital.
Do not:
1)Do not use a tourniquet: This can cause severe tissue damage, including gangrene, and is no longer recommended.
2)Do not cut the bite or suck out venom: These actions are ineffective and can introduce infection.
3)Do not apply ice or cold packs: Local cooling can worsen tissue injury.
4)Do not give the patient alcohol or caffeine: These substances may speed up the absorption of venom.
5)Do not attempt to catch or handle the snake: Instead, try to remember its appearance (color and shape) or take a picture from a safe distance for identification.
Hospital management and treatment
1)Vital signs: Routine vital signs, including heart rate, blood pressure, and respiratory rate, will be monitored.
2)Lab tests: Blood tests such as a complete blood count, coagulation studies (prothrombin time, partial thromboplastin time), and kidney function tests are performed to detect systemic effects.
3)The 20-minute Whole Blood Clotting Test (20WBCT): This simple bedside test is used in resource-limited areas to screen for coagulopathy. If the blood remains unclotted after 20 minutes, it indicates a clotting disorder and the need for antivenom.
4)Antivenom: This is the only specific treatment for snake envenomation. The decision to administer antivenom depends on the development of systemic toxicity or rapidly progressing local effects.
Adverse reactions:
Patients are monitored for adverse reactions, such as anaphylaxis, during and after antivenom administration. Emergency treatment for anaphylaxis, including adrenaline, should be available.