1. Training on Road Traffic accident and snake
venom poisoning
1st June, 2021
Barishal Sadar
Dr. Akif Ibn Salam
Assistant Surgeon
Barishal Sadar, Barishal
2. Management of snake venom poisoning
7,00,000 people get bitten by snakes annually
in Bangladesh
6,000 deaths
Clinical features:
3. Diagnosis:
First Aid methods:
1. Reassurance
2. Immobilization
3. Wash the bitten area
4. Remove as early as possible all rings, bangles, anklets, cords or clothing
5. Quick transport
6. Place patient in the lateral recumbent position.
7. If non-breathing, insert an oral airway or perform rescue breathing if necessary
8. If the snake is killed somehow, bring it to hospital.
Management of snake venom poisoning
4. Some Don’ts:
1. Do not apply tourniquets/ligature in the bitten limb.
2. Do not cut or prick with needles or use any topical cream.
3. Do not waste time unnecessarily seeking treatment provided by traditional
healers
4. Do not provide anything by mouth if the victim has difficulty in
swallowing/talking, vomiting, nasal voice or excessive salivation.
5. Do not cauterize by using chemicals.
6. Do not apply herbal medicines, stones, seeds, saliva, potassium permanganate
solution or cow-dung and mud.
7. Do not give herbal products like oil, ghee, pepper to induce vomiting.
8. Do not apply alcohol.
9. Do not give aspirin to relieve pain.
10. Do not panic and be tempted to do anything detrimental to the victim.
11. Do not delay in reaching health facility.
Management of snake venom poisoning
5. Road traffic accident management guideline
Accident In Bangladesh
4702
5227
6953
Number of accidents
Deaths
Injured
In 2019
6. Management of poly-traumatized patient
There are many protocols for management of polytrauma, the most universally
accepted one is the protocol of ATLS (ADVANCED TRAUMA LIFE SUPPORT)
Primary survey.
Secondary survey
Definitive treatment.
Another protocol is the 5 Rs
R1: Rapid Evaluation = Triage.
R2: Resuscitation.
R3: Radiology and Other Investigations.
R4: Re-Evaluation.
R5: Repair and Rehabilitation.
Road traffic accident management guideline
7. Rapid Evaluation = Triage
Black (White) Zone
Red Zone
Yellow Zone
Green Zone
Resuscitation
A-Airway
B-Breathing
C-Circulation
D-Disability (Neurological Assessment)
E-Exposure
Road traffic accident management guideline
8. Radiology & Other Investigations.
I- Basic X- Ray Films
II- Focused Assessment with Sonography for Trauma (FAST)
III-CT Scans
IV - DPL (Diagnostic Peritoneal Lavage):
Re-Evaluation (Secondary survey)
1. History taking
2. General Examination from Hair to Heal
Road traffic accident management guideline
