ASV Dosage in Victims Requiring Life Saving Surgery
\nIn very rare case of snake bite life saving surgery is required in order to save the
\nvictim. An example would be a patient who presents with signs of an intracranial
\nbleed. Before surgery can take place, coagulation must be restored in the victim in
\norder to avoid catastrophic bleeding. In such cases a higher initial dose of ASV is
\njustifi ed (upto 25 vials) solely on the basis of guaranteeing restoration of coagulation
\nafter 6 hours.
\nVictims Who Arrive Late
\nA frequent problem is victims who arrive late after the bite, often after several
\ndays, usually with acute renal failure. Should the clinician administer ASV? The key
\ndetermining factor is, are there any signs of current venom activity? Venom can only be
\nneutralised, if it is unattached! Perform a 20 WBCT and determine if any coagulopathy
\nis present. If coagulopathy is present, administer ASV. If no coagulopathy is evident,
\nassess the case for evidences for one or other complications and consequences secondary
\nto complication of snake bite. Such cases require appropriate supportive measures.
\nIn the case of neurotoxic envenoming where the victim is having symptoms such
\nas ptosis, respiratory failure etc, it is probably wise to administer one dose of 8-10 vials
\nof ASV to ensure that no unbound venom is present. However, at this stage it is likely
\nthat all the venom is bound and patient requires respiratory support.
\nSnake bites Again!
\nIf a patient has been bitten by a poisonous snake and received ASV earlier and
\ncomes back with features of repeat snake bite, he \/ she may be considered as a fresh
\ncase and treated accordingly (Whatever the interval between the snakebite). However,
\ncare should be taken while administering ASV, since he \/ she has been sensitised.
\nPregnancy and Lactating woman
\nThere is very little defi nitive data published on the effects of snakebite during
\npregnancy. Though spontaneous abortion of the foetus has been reported, this is not the outcome in the majority of cases. It is not clear if venom can pass the placental
\nbarrier. Pregnant women are treated in exactly the same way as other victims. The
\nsame dosage of ASV is given. The victim should be re-assessed for the impact on the
\nfetus. One should be alert and rule out retro placental clot. The effects of venom and
\nantivenom on the mother and fetus need further exploration. ASV may be administered
\nto lactating woman if bitten by a poisonous snake and be treated like any other persons.
\nBreast feeding is not contraindicated.
\nOthers:
\nEven if the patients belong to any of the following category viz., autoimmune
\ndisorders, debilitating status, endocrine disorders, Immuno-suppressed status, HIV\/
\nAIDS, cancer, asthma and allergic disorders or any other illness arrive with features of
\nsnake envenomation, they also require ASV in the same manner like any other case of
\npoisonous snake bite.<\/p>\n","protected":false},"excerpt":{"rendered":"
ASV Dosage in Victims Requiring Life Saving Surgery In very rare case of snake bite life saving surgery is required in order to save the victim. An example would be a patient who presents with signs of an intracranial bleed. Before surgery can take place, coagulation must be restored in the victim in order to […]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":21,"menu_order":5,"comment_status":"open","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-42","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/42","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/comments?post=42"}],"version-history":[{"count":0,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/42\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/21"}],"wp:attachment":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/media?parent=42"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}