Management Of Snakebites

Snakebites are well-known medical emergencies in many parts of the world especially in rural areas. Agricultural workers and children are most affected. The incidence of snakebite mortality is particularly high in South-East Asia. Rational use of snake anti-venom can substantially reduce mortality and morbidity due to snake bites. These guidelines are a revised and updated version of those published in 2011. The geographical coverage extends from India in the west to DPR Korea and Indonesia in the east Nepal and Bhutan in the north and to Sri Lanka and Indonesia in the south and south-east. Snakes inhabiting the Indonesian islands east of Wallace?s line (West Papua and Maluku Islands) are part of the Australasian elapid fauna differing from those west of this line. This publication aims to pass on a digest of available knowledge about all clinical aspects of snake-bite to medically trained personnel including medical doctors nurses dispensers and community health workers. They aim to provide suffcient practical information to allow medically trained personnel to assess and treat patients with snake-bites at different levels of the health service.

This publication aims to provide useful information mainly to those who must diagnose and treat people envenomed by snakes, and to pass on a compilation of available knowledge about all clinical aspects of snakebite to medically trained crew. It is a good source of comprehensive information about essential drugs for snakebite treatment - specific antidotes to the snake venoms, particularly the one that is produced today in the United States. The reader can use the knowledge in this book to the advantage of ones who need it - snakebite victims. This book contains information obtained from authentic and highly regarded sources. Systematic reviews of available updated literature, expert opinions, results of recent clinical studies as well as our own experience were used.

This book is the first significant contribution to thoroughly examine the potential hazards associated with snakes of the former family, Colubridae. This family contained >65% of living snake species (approximately 3,000 taxa) and has recently been split into multiple families. Many of these snakes produce oral secretions that contain toxins and other biologically-active substances. A large variety of these snakes figure in the pet industry, yet little documented information or formal study of their potential medical importance has been published. Therefore, although the possible medical importance of many of these species has been subjected to speculation since the mid-nineteenth century, there is a limited amount of useful descriptive information regarding the real hazard (or lack thereof) of snakes belonging to this diverse, artificial family. There is a need for "one-stop shopping" offering information regarding their possible toxicity and clinical relevance as well as recommendations for medical management of their bites. This book is the first synthesis of this information and includes evidence-based risk assessment, hazard rankings and specific recommendations regarding important species, many common in captivity. Fills a gap in the toxinological, medical and herpetological literature by providing a comprehensive review of this entire assemblage of snakes, with particular attention given to their capacity, real or rumored, to cause harm to humans A patient-centered, evidence-based approach is applied to analyzing documented case reports of bites inflicted by approximately 100 species. Clinical management of medically significant bites from non-front-fanged colubroids is methodically reviewed, and specific recommendations are provided

Clinical toxinologic conditions are becoming increasingly frequent, more so than is generally recognized. The conditions comprise of clinical aspects such as the diagnosis, management, and prevention of snakebite envenoming, scorpion sting, mushroom toxins, plant toxins, and other natural toxins. Clinical toxinology also deals with the ecology, epidemiology, regional differences, and varieties of fauna accounting for different envenoming manifestations. This handbook includes 30 chapters addressing various topics on clinical toxinology such as the epidemiology and management of snakebites in different Asian and African countries, disability following snakebite, effect of snake venoms on hemostasis, socioeconomic aspects of snakebites, therapeutic application of snake venom, scorpion sting in the Middle East, jellyfish sting, etc. These titles are written by experts currently working in the subspecialty, many of whom have first-hand experience in the relevant research fields. In virtually all the topics, appropriate illustrations are provided to simplify comprehension including tables, figures and pictures. This reference work on Clinical Toxinology in Asia Pacific and Africa, in the Toxinology handbook series, is designed to keep readers abreast with new knowledge and experience in toxinology regionally and globally. Toxinologists, researchers, scientists, and experts in this field from various working areas considered it necessary to collect all the aspects of clinical toxinology in a single, handy handbook. This can be used by medical students, postgraduate students, general practitioners, specialists in internal medicine, critical care physicians, emergency physicians, and anesthetists worldwide.

The ultimate guide to the evidence-based clinical encounter "This book is an excellent source of supported evidence that provides useful and clinically relevant information for the busy practitioner, student, resident, or educator who wants to hone skills of physical diagnosis. It provides a tool to improve patient care by using the history and physical examination items that have the most reliability and efficiency."--Annals of Internal Medicine "The evidence-based examination techniques put forth by Rational Clinical Examination is the sort that can be brought to bear on a daily basis – to save time, increase confidence in medical decisions, and help decrease unnecessary testing for conditions that do not require absolute diagnostic certainty. In the end, the whole of this book is greater than its parts and can serve as a worthy companion to a traditional manual of physical examination."--Baylor University Medical Center (BUMC)Proceedings 5 STAR DOODY'S REVIEW! "Physical diagnosis has been taught to every medical student but this evidence-based approach now shows us why, presenting one of medicine's most basic tenets in a new and challenging light. The format is extraordinary, taking previously published material and updating the pertinent evidence since the initial publication, affirming or questioning or refining the conclusions drawn from the data. "This is a book for everyone who has studied medicine and found themselves doubting what they have been taught over the years, not that they have been deluded, but that medical traditions have been unquestionably believed because there was no evidence to believe otherwise. The authors have uncovered the truth. "This extraordinary, one-of-a-kind book is a valuable addition to every medical library."--Doody's Review Service Completely updated with new literature analyses, here is a uniquely practical, clinically relevant approach to the use of evidence in the content of physical examination. Going far beyond the scope of traditional physical examination texts, this invaluable resource compiles and presents the evidence-based meanings of signs, symptoms, and results from physical examination maneuvers and other diagnostic studies. Page after page, you'll find a focus on actual clinical questions and presentations, making it an incomparably practical resource that you'll turn to again and again. Importantly, the high-yield content of The Rational Clinical Examination is significantly expanded and updated from the original JAMA articles, much of it published here for the first time. It all adds up to a definitive, ready-to-use clinical exam sourcebook that no student or clinician should be without. FEATURES Packed with updated, new, and previously unpublished information from the original JAMA articles Standardized template for every issue covered, including: Case Presentation; Why the Issue Is Clinically Important; Research and Statistical Methods Used to Find the Evidence Presented; The Sensitivity and Specificity of Each Key Result; Resolution of the Case Presentation; and the Clinical Bottom Line Completely updated with all-new literature searches and appraisals supplementing each chapter Full-color format with dynamic clinical illustrations and images Real-world focus on a specific clinical question in each chapter, reflecting the way clinicians approach the practice of evidence-based medicine More than 50 complete chapters on common and challenging clinical questions and patient presentations Also available: JAMAevidence.com, a new interactive database for the best practice of evidence based medicine

Nephrology is one of the fastest growing specialties in medicine. Nevertheless, kidney disease is one of the most serious unmet health needs in many countries. To provide healthcare access with the desirable equity worldwide, the nephrology community needs to discuss this public health issue and take part in decisions for elaboration of public health policies with more justice and equity. This book brings together key current public health problems that affect kidney function and illuminates them in contributions by an international group of nephrologists and general practitioners. The chapters review current knowledge and provide guidelines to manage these conditions and decrease the disease burden. At the end, developments in the digital era and their application to kidney disease treatment are synthesized, and a broader outlook on the future of nephrology is given. Ultimately, the publication aims to gather nephrology and public health expertise from researchers from all over the world, providing a broad vision of issues that must be discussed and overcome to guarantee a better treatment for patients with kidney diseases in the world today.