about snake bite ,venom,types of venom,first aid,antivenom,and management ,epidemiology ,dosage and route of antivenom administration , anaphylactic reaction due to antivenom , general symptoms of snake bite,immobilization process , formation of antivenom
poisoning, its types and emergent management.bhartisharma175
it explain about definition, causes, types of poison, severity , diagnostic evaluation, complication of poisoning, emergent management, supportive management and nursing management.
Anatomical and physiological description of Dristi in Ayurveda Ophthalmology which gives insight for understanding of entire posterior segment eye disorders.
first aid in Insects bites and heat stroke.pptxanjalatchi
Most insect bites and stings are mild and can be treated at home. They might cause itching, swelling and stinging that go away in a day or two. Some bites or stings can transmit disease-causing bacteria, viruses or parasites. Stings from bees, yellow jackets, wasps, hornets and fire ants might cause a severe allergic reaction (anaphylaxis).
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
It has been prepared according to national guideline on snake bite management in Bangladesh. It would be very much helpful for health care professionals working in Bangladesh
poisoning, its types and emergent management.bhartisharma175
it explain about definition, causes, types of poison, severity , diagnostic evaluation, complication of poisoning, emergent management, supportive management and nursing management.
Anatomical and physiological description of Dristi in Ayurveda Ophthalmology which gives insight for understanding of entire posterior segment eye disorders.
first aid in Insects bites and heat stroke.pptxanjalatchi
Most insect bites and stings are mild and can be treated at home. They might cause itching, swelling and stinging that go away in a day or two. Some bites or stings can transmit disease-causing bacteria, viruses or parasites. Stings from bees, yellow jackets, wasps, hornets and fire ants might cause a severe allergic reaction (anaphylaxis).
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
It has been prepared according to national guideline on snake bite management in Bangladesh. It would be very much helpful for health care professionals working in Bangladesh
This pptx is on recognition of different snakes, snake bite management particularly in children. At the end of the slide show you will definitely able to recognize and manage snake bites.
Most of the world's snakes are what are referred to as clinically non-venomous. This means they do not produce a toxin that is clinically significant to people.
Snake bite basics in a visually appealing format for general population, school and college students, medical students, paramedics, nurses, and pg residents. Snakes included only pertaining to indian subcontinent. Any medical data given is valid only for indian subcontinent.
"Venomous Encounters: Understanding the Physiology, Treatment, and Prevention...krjx9cpvdg
Snake bites epitomize a multifaceted intersection between humans and reptiles, often culminating in dire consequences. The intricate dynamics of venom delivery mechanisms and their intricate interplay with the human physiology underscore the urgency of comprehensively understanding and addressing this complex issue.
Venomous snakes, equipped with specialized fangs honed by evolution, wield venom as a potent weapon. This venom, a sophisticated blend of toxins, serves diverse purposes, including immobilizing prey, aiding in digestion, and self-defense. The composition of snake venom varies markedly across species, each venom boasting a unique concoction of enzymes, peptides, and proteins meticulously tailored to disrupt physiological functions in their unsuspecting victims.
The ramifications of a snake bite can be profound and diverse, spanning from localized tissue damage and systemic toxicity to potentially life-threatening complications. The severity of envenomation hinges on myriad factors, including the potency of the venom, the volume injected, the site of the bite, and the health status of the victim. Neurotoxic venoms, for instance, can precipitate paralysis and respiratory failure, while hemotoxic venoms may induce extensive tissue necrosis and coagulopathies, underscoring the pernicious diversity of snakebite outcomes.
Timely recognition and appropriate management are pivotal in mitigating the impact of snake bites. Immediate implementation of first aid measures, such as immobilizing the affected limb, maintaining the victim's composure, and promptly seeking medical assistance, can substantially ameliorate outcomes. In regions where venomous snakes hold sway, access to antivenom and proficient healthcare professionals assumes paramount importance for efficacious treatment.
Nonetheless, the challenges posed by snake bites transcend the confines of mere medical intervention. Socioeconomic determinants, encompassing factors like limited healthcare accessibility, inadequate infrastructure, and geographical remoteness, can markedly exacerbate the burden of snakebite-related morbidity and mortality, particularly among marginalized populations.
Preventive strategies wield considerable influence in curtailing the incidence of snake bites and attenuating their repercussions. Educational initiatives geared toward disseminating knowledge about snake behavior, imparting proficiency in first aid techniques, and advocating preventive measures like donning protective attire and circumventing high-risk locales constitute indispensable pillars of snakebite prevention.
Furthermore, endeavors aimed at conserving snake habitats and fostering cohabitation between humans and serpents are pivotal for long-term snakebite mitigation. By fostering an understanding of the ecological roles of snakes and championing their conservation, societies can engender an environment conducive to harmonious coexistence between humans and reptiles.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
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the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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4. Snake
A long limbless reptile which has no
eyelids ,a short tail, and jaws that are
capable of considerable extension .
5. Introduction
Snake bite are punctured wounds caused by the
fangs of snakes where it release it’s venom.
• 3500 Species found globally 500 species are
poisonous
• In Nepal 77 species known, 22 of these are
poisonous. Studies in Nepal have identified 4
species of snake responsible for fatal bites. They
are indian cobra(naja naja),common krait(bungaris
caeruleus), Russell’s viper(viper ressellii) and
greenpit viper
7. Epidemiology
There are at least 40,000 cases of snakebite every
year in Nepal,with some fatalities in terai alone.
Death rate has come down from 18.7% 20 years
ago to 6.62% . India has the highest number of
deaths due to snake bites in the world with 35,000–
50,000 people dying per year according to World
Health Organization (WHO) direst estimates. South
Asia has the highest incidence and mortality rates of
snake bite in the world.
8. Venom
A poisonous substance secreted by animals
such as snakes,spiders ,and scorpions and
typically injected into prey by biting or stinging.
Freshly secreted venom is transparent and
pale.
On storing and on exposure to light it
becomes yellowish and opaque
9.
10. Component of venom
Contains 20 different constituents mainly
proteins including enzymes and polypeptide
toxins.
Procoagulants
Other cytolytic or necrolytic toxins
11.
12. Difference between poisonous and non
poisonous snake
S.N Poisonous snake Non-poisonous snake
1 Fangs are hollow like hypodermic
needle
Fangs are short and solid
2 Belly scales are large and cover
entire breadth
Belly scales are like those on back
and don’t cover the entire breadth
3 Teeth are two long fangs Teeth are several and small
13. Classification of venom
1. Haematotoxic venom
2. Neurotoxic venom
3. Myotoxic venom
4. Cytotoxic venom
(NOTE- Most snakes have both type of venoms but one
is dominant to the other.)
14. 1.Haematotoxic venom
Affect blood and circulation . The prey dies from
cardiovascular failure and bleeding.
Sign and symptoms
Vomiting
Numbness , confusion
Intense pain
Bruising , bleeding
Rapid pulse
15. 2.Neurotoxic venom
Affects the nervous system and brain.
Signs and symptoms
Ptosis
Respiratory paralysis
Double vision,dilated pupil
Sweating,vomiting
Excessive salivation
Muscle paralysis
It takes about 10 min for the venom to affect nervous system
Neurotoxic symptom usually resolve in 2-3 days
16. 3.Myotoxic venom
Affect muscle tissue
Sign and symptoms
Most important symptom are rhabdomyolysis(rapid
breakdown of skeletal muscle tissue)and paralysis
Disable muscle contraction
Pain in legs ,hips and shoulders,with paralysis and
damage to kidney
17. 4.Cytotoxic venom
Destroy cells
Sign and symptoms
Bleeding , Blistering and discolouration
Painful and progressive swelling
Examples of venom
Sea MY HEAVY NECK
Myotoxic -Sea Snake
Hematotoxic – Viper (Viperidae)
Neurotoxic- Cobra, Krait (Elapidae)
18.
19. Management
1) First aid treatment and transport to hospital
2) Rapid clinical assessment and resuscitation
3) Antivenom treatment
4) Treatment of bitten part
5) Prevention
20. 1.First aid
a. Reassurance
The victim may be frightened and anxious . Reassure
victim on that it is a treatable condition . The confirmation can be
done by presence of teeth prints . Remove tight clothes,rings etc
from bitten limb .
b. Immobilization
Immobilize the bitten limb with a splint or sling . Any cloth or
bandage may be used for this. Any form of movement cause musle
contraction that will increase absorption and spread of venom by
squeezing vein . Keep the affected limb as low level as possible .
Regularly check circulation in fingers or toes.
c. Rapid transport
21.
22. First aid if venom enter in eye
I. Irrigating the eye with water or if possible normal
saline
II. A single application of local anesthetic eye drops
helps to overcome tightly closed eyelids and facilitates
irrigation
III. Antivenom treatment is not indicated
23. First aid of bite to trunk
If possible apply firm pressure over the bitten area.
Donot restrict chest movement and keep patient still
First aid of bite in neck
There is no first aid keep patient still and take to
hospital
24. Do’s
Immobilize the limb
Get to hospital immediately . traditional remedies
have no proven benefit in treating it
Tell the doctor if any systemic symptom that
manifest on the way to hospital
25. Don’t
Interfere with bitten area
Suck by mouth
Apply chemicals
Use tourniquets
Cooling agents on bitten area
Make incision
Walking
Give anything to eat
26. 2.Rapid clinical assessment and resuscitation
It is a medical emergency. Therefore a quick clinical assessment
should be done to decide if patient needs immediate resuscitation
or antivenom therapy . Rapid clinical assessment and resuscitation
using ABCDE( airway , breathing, circulation,disability of nervous
system , exposure and environmental control ) approach should be
initiated .
Airway obstruction or respiratory failure caused by neurotoxic
envenoming requires immediate airway support
In case of russells viper bite,shock may occur because of
hemorrhage due to incoagulable blood , fluid shift into bitten
limb,myocardial depression . This patient must be treated promptly
with rapid infusion of normal saline and antivenom started as soon
as possible .
27. 3. Antivenom treatment
►It is only effective treatment for snake bite envenoming . It is
prepared from animals plasma ( most often horses , but also
donkey or sheep ) after hyper immunized against venom of snakes
►The currently available antivenom in Nepal is imported from
india and is polyvalent(hyperimmunized against venom of several
snake species) available in lypophilized powder form . Each vial is
reconstituted with 10ml of sterile water for IV administration. It is
effective against 4 common species of snakes found in india ;
Russells viper (Daboia russelii), common cobr (naja naja) ,common
krait (bungarus caeruleus) and saw scaled viper (echis carinatus).
Saw scaled is not yet reported from Nepal .
28.
29. Indication for administering antivenom
Administration of antivenom carries risk of
anaphylactic reaction and should not therefore be
used unnecessarily
Evidence of neurotoxicity
Evidence of coagulopathy which is detected by
bleeding
Evidence of cardiovascular collapse eg. Shock and
hypotension
30. Route of administration and dosage of
antivenom
Adult
Reconstituted antivenom is diluted in 5-10 ml/kg body
weight (approx. 250-500 ml) of isotonic saline or glucose
and administered as infusion @2ml/min.
Children
Reconstituted antivenom is diluted in 3-5 ml/kg body
weight of isotonic saline or dextrose water and
administered as infusion @2ml/min
Reconstituted antivenom is administerd by slow iv
@2ml/min however,this route is not practiced commonly
31. Neurotoxic envenoming
Initial dose 10 vials (100) ml is further diluted or
mixed with dextrose water or saline(100
ml to 400 ml) . Then it is administered with
iv infusion at rate of 2ml/min (@60-70
drops /min).
Repetition of antivenom dose If neurological signs deteriorates an iv
push of 5 vials of antivenom (50ml)
reconstituted antivenom should
administer @2ml/min
Note :donot repeat if neurological sign
persist.repeat only if deteriorate
Cont…
32. Hematotoxic envenoming
Initial dose Same as for neurotoxic envenoming
Repetition of
dose
Persistence of blood incoagulability
after every 6 hr of antivenom dose .
Repeat coagulation test if it comes
abnormal repeat 5 vials of antivenom
(50 ml reconstituted antivenom) iv
push@2ml/min
Cont…
33. Observation and monitoring
Patient receiving antivenom requires continuous
observation and frequent monitoring of vital signs .
The anaphylaxis reaction may be life threatening so
adrenaline(s/c) must be kept ready . 3 types of
antivenom reaction can occur ,early anaphylactic
reaction (EAR) , pyrogenic reaction and late
reaction .
34. Detection of early EAR and PR (pyrogenic
reaction
It usually occurs within 3hours after initiation of
antivenom administration. Following are associated
features :
1) Itching,urticaria,swollen lips or tongue
2) Respiratory symptoms:dry
cough,wheezing,stridor,hoarse voice
3) Nausea,vomiting,diarrhea
4) Airway obstruction,fever
5) Tachypnea,shock Urticaria
35. 4.Treatment of bitten part
1) Elevation of limb with rest
2) Simple washing with antiseptic solution like
chlorhexidine , povidone iodine etc
3) In case of local necrosis and gangrene surgical
debriment should done
4) Snakebites are considered tetanus prone wounds
.so,tetanus toxoid IM injection should given . If patients
presents with coagulopathy , it should postponed until
after resolution of coagulopathy .
36. 5.Prevention
It is a seasonal events . It occurs when snake comes out of hibernation
and after rain . Following preventive measures should be taken :
1) Keep household clean by cutting grasses,bushes building materials
etc from near and around house .
2) Close door ,windows properly so that snake cannot enter house.
3) Try to avoid sleeping on floor . If it is unavoidable ,then mosquito net
should be used and tucked well.
4) Use light when you walk outside the house at night .
5) Use high shoes or boots while walking in paddy field .
6) Never insert hands into long grasses,holes etc
7) Shoes and clothes should be check before wearing .