Antivenom for snake bite in Korea.
10.5124/jkma.2013.56.12.1091
- Author:
Hoon LIM
1
;
Hyung Goo KANG
;
Kyung Hwan KIM
Author Information
1. Department of Emergency Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
- Publication Type:Original Article
- Keywords:
Snake bites;
Venoms;
Antivenom
- MeSH:
Analgesia;
Anti-Bacterial Agents;
Blood Platelets;
Epinephrine;
Extremities;
Humans;
Inflammation;
Korea*;
Necrosis;
Nociceptive Pain;
Poisoning;
Snake Bites*;
Snake Venoms;
Snakes*;
Venoms
- From:Journal of the Korean Medical Association
2013;56(12):1091-1103
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
In Korea, there are four types of snakes, Glyoidius brevicaudus, G. intermedius (formerly named, saxatilis), G. ussuriensis, Rhabdophis tigrinus. The case-fatality rate in snake bite envenomation is very low. Snake venom is a heterogeneous mixture of pharmacologically active enzymatic, non-enzymatic protein, peptide toxins, other organic and inorganic substances. The pathophysiology evokes a complex series of events that depend on the combined and synergistic action of toxic and non-toxic components. The manifestation includes local and systemic effects. Local tissue effects includes of tissue pain, redness, swelling, tenderness, bullae formation, and necrosis. The major systemic manifestations of snake bite include neurotoxicity, myotoxicity, cytotoxicity, hemolytic, procoagulant, hemorrhagic, and hypotensive effects and interfere in platelet function. General care includes parenteral analgesia, antivenom administration, and serial assessments of limb swelling and laboratory tests. Despite the presence of soft tissue inflammation, prophylactic antibiotics are rarely required, and most patients achieve good outcomes with supportive care and antivenom alone. In the case of mild poisoning do not need to be treated with antivenom. In moderate to severe envenomation, antivenom should be administered. When administered antivenom, adverse reactions are monitored closely and treated early with epinephrine and anti-histamine. In future, we should establish algorithm provides guidance about clinical and laboratory observations, indications for and dosing of antivenom, adjunctive therapies, post-stabilization care, and management of complications from envenomation and therapy.