Procurement and Supply of Anti Snake Venom as a Determinant of Snake Bite Management Outcome at a Government Medical College Hospital in Karnataka

Abstract

Context: Snake bite poisoning, is an important reason for hospitalization and death in rural India. Availability and timely administration of anti snake venom (ASV) at hospitals is an important factor in favourable prognosis for snake bite victims. Aims: To determine i. proportion of venomous bites to non venomous bites ii. proportion of snake bite cases administered Anti snake venom iii. supply and utilization of Anti snake venom in one year period for treating snake bite victims Settings and Design: A Cross sectional, study was conducted in a Government Medical college hospital in Mandya, Karnataka from November 2012 to October 2013 to ascertain ASV utilization. Methods and Material: Data was collected from hospitalized snake bite victims, from medico legal register (deaths) and in-patient records. Information on ASV stock and supplies, was obtained from the hospital main stores and ward indents. Statistical analysis used: Frequencies and Proportions. Results: 376 (n) snake bite cases were admitted to the hospital during the period, of which 77 victims (20.47%) had envenomation (including 4 deaths). Of 920 anti snake venom vials procured and supplied to the hospital, 915 vials were used, of which 531 vials (58.03%) were administered to those correctly diagnosed to have envenoming. 189 (50.13%) victims who were later diagnosed not to have envenoming, received 384 vials (41.97%). Conclusions: ASV utilization is complete and on a few occasions excessive. All cases of envenoming were not given 10 vials of ASV as suggested in the protocol. Some cases received 2 vials at admission and recovered.