A prospective analysis of adherence to standard treatment guidelines in management of snakebite in a tertiary care teaching hospital of rural Bengal, India

ABSTRACT

Background: Rural Bengal has one of the highest snakebite prevalence in India. This prospective observational study was initiated with the motive to analyse the effects and adherence to implementation of the new national snakebite protocol 2016.Methods: Data were collected from the patients admitted with snake bite on a pre-designed and pre tested case study form and analysed with the help of descriptive statistics.Results: A total of 75 patients arrived in the hospital during the study period out which 53 were male (most in the age group of 31-40 years) and majority of them were farmers (26.6%) or housewives (25%). Maximum of them were bitten in the lower limbs (54.6%) and peak time of bite was between 6 am-12 pm (40%). Most of them reached the hospital late, i.e., beyond 2 hours (70.6%). It was found that there were 26 neurotoxic, 16 hemotoxic and 1 neuro-hemotoxic cases and the rest were non-venomous cases. Fifty-one of them received ASV and 4 died. There was 80% adherence in the indication of ASV administration, 73.3% in the ASV dose, 32% in the monitoring after ASV administration, 94.66% in the monitoring 20 WBCT, 100% in adherence to haemodialysis as indicated.Conclusions: The results showed good adherence in all the parameters. Protocol guided treatment has also resulted in rational use of ASV. So, from this study, it was concluded that protocol guided treatment is effective in snakebite management, but its continuous revision and amendments should be considered in future.