Management of Snake Bite, Dog Bite & Animal Bite

Management of Snake Bite

• Do it “R I G H T”.

              R = Reassure

               I = Immobilize

          GH = Go to Hospital

             T = Tell the doctor.

• No tying of ligature.
• No application of anything at site of bite.
• Anti-Venom Serum (AVS) – available in all bedded
  Govt. health facilities.
• AVS is “the treatment” of any poisonous bite of
   snake.
• Compensation of Rs.1 lakh admissible for snake bite
   death, from Block Disaster Management Officer.
• Post-mortem examination report or certificate from
   treating hospital – mandatory for the compensation.

So patient to be taken to a bedded hospital of modern
system, not elsewhere !

• 3 categories of poisonous snakes:
       - Neurotoxic e.g. keute, gokhro, kalach
       - Haematotoxic e.g. vipers
       - Sea snakes; bite rare in W.Bengal.
• Bite marks are of no use to decide treatment.
• Snake need not be caught and shown to the doctor.
• Signs of envenomation may be delayed till 24 hours
  of bite (even 36 hours in a few cases).
• So snake bite to be admitted and kept for at least 24
   hours even if no AVS is required.
• Snake bite vs. scorpion bite (tremendous pain but no
   swelling).
• Symptoms of kalach bite may be very weird!

Dog/animal bite

• Risks are:
      Tissue injury & bleeding
      Wound sepsis
      Tetanus
Rabies.
   • These bites may result in rabies:
       Dog, cat
      Monkey
      Horse, cattle
      Mongoose
     Any bite by wild animal
  

• Rabies infection possible through droplet infection in
   caves infested with bats; not reported in India.

• No significant risk of rabies:
  - Bite of house rats or moles.
  - Ingestion of milk of cow bitten by rabid dog.

• Bite by pet dog/ vaccinated dog:
 - Treatment is necessary.

First aid
• Thorough washing with soap & running water.
• No stitching.
• Apply a disinfectant like tinc. iodine/betadine, savlon,
rect. spirit etc.
• No application of any other thing at site of bite.

Go to an Anti-Rabies Clini
  • In each Block, there is at least one Anti-Rabies Clinic;
     usually in the Block PHC/ Rural Hospital.
 • Anti-Rabies Vaccine (ARV) is supposed to be available
    there.
 - ARV to be given also for a simple scratch (even
    if no blood comes out).
• Rabies Immunoglobulin (RIG) may be necessary in
   selected grades of bites. Should be given as early as
   possible.
• We use intradermal rote for ARV.
• 4x2 injections on Day-0, Day-3, Day-7 and Day-28.
• Bite of dog: If dog is ok after 10 days of bite, Day-28
injection not required.
• F.A.Q. on Animal Bite Management available in IDSP
menu of www.wbhealth.gov.in