Emergency

Snake Bite

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Treatment protocol (medical unit protocol shown in the book): start as soon as possible, give 5 ampoules of polyvalent anti-snake venom diluted in 500–1000 mL of 5% D/W over 30–60 minutes, and watch for anaphylaxis.

ICD-10: —
Source: OPD handbook pp.179–180
Status: Draft

Not yet reviewed by a clinician. Check doses and brands against current national guidelines before use.

Symptoms

Snake bite

Red flags Refer urgently if any are present

Anaphylaxis during antivenom infusion

Diagnosis

There is no absolute contraindication, but high-risk patients are those with a history of previous severe reaction, a history of atopic disease, and asthmatics

Treatment

Step 1 of 3

1. Antivenom

Start treatment as soon as possible
Give 5 ampoules of polyvalent vaccine (antivenom) diluted in 500–1000 mL 5% D/W, infused over 30–60 minutes

Prescription

Polyvalent anti-snake venom (ASV)Antivenom

Dose5 ampoules in 500–1000 mL 5% D/W over 30–60 minutes

Brands Generic / hospital supply

5% Dextrose in water (D/W) IVIV fluid

Dose500–1000 mL (diluent)

Brands Generic / hospital supply

Step 2 of 3

2. If any sign of anaphylaxis

Stop the infusion immediately
Inj adrenaline 0.5 mg IM in the upper lateral thigh; the dose may be repeated after 5–10 minutes
Inhaled salbutamol with oxygen
Inj chlorpheniramine (Avil) 10 mg IV stat
Inj hydrocortisone 100 mg IV stat

Prescription

Adrenaline (epinephrine) injectionEmergency drug (anaphylaxis)

Dose0.5 mg IM upper lateral thigh; repeat after 5–10 minutes

Brands Generic / hospital supply

Salbutamol (inhaled)Bronchodilator

DoseInhaled with oxygen

Brands Generic / hospital supply

Chlorpheniramine injectionAntihistamine (anaphylaxis cover)

Dose10 mg IV stat

Brand Inj Avil

Hydrocortisone injectionCorticosteroid

Dose100 mg IV stat

Brands Solu-Cortef

Step 3 of 3

3. Continue

Continue treatment as long as signs and symptoms persist