The medical offi cer who is treating the cases of snake bite should take meticulous
\ncare to look in to the patient\u2019s status and provide fi rst aid as well as supportive measures
\nbefore referring the case to higher centre \/ speciaslist. The details are furnished in
\nTable 15 below.
\nTable No. 15: Referral aspects for snakebite
\nWho needs?
\nPatient requiring
\n\u2022 Respiratory support
\n\u2022 Deteriorating
\nneurologic
\nmanifestations
\n\u2022 Surgical
\nintervention-Necrosis
\n\/ Fasciotomy
\n\u2022 Spontaneous
\npersistent bleeding
\n\u2022 Co-morbid diseases
\n\u2022 Acute impending
\nkidney failure
\nWhen to refer?
\nRefer the patient
\nafter stabilising the
\ncase and after giving
\ninjection ASV (Refer
\nto Annexure VIII and
\nIX)
\nWhere to refer?
\nRefer to higher institution
\nhaving
\n\u2022 Ventilator
\n\u2022 Dialysis facilities
\n\u2022 Measures to provide
\nfurther supportive
\ntreatment.
\nReferral Criteria for Haemotoxic envenomation
\nOnce the ASV is fi nished and the adverse reaction dealt with the patient should be
\nautomatically referred to a higher centre with facilities for blood analysis to determine
\nany systemic bleeding or renal impairment. The 6 hours rule ensures that a six hours
\nwindow is now available in which to transport the patient.
\nReferral Criteria for Neurotoxic envenomation
\nIf after one hour from the end of the fi rst dose of ASV, the patient\u2019s symptoms have
\nworsened i.e., paralysis has descended further, a second full dose of ASV is given over
\none hour. ASV is then completed for this patient. If after 2 hours the patient has not
\nshown worsening symptoms, but has not improved consider this case for referral to a
\nhigher centre
\nInstructions while referring
\n\u2022 Inform the need for referral to the patient and \/ care giver [family member or
\nthe accompanying attendant]
\n\u2022 Give prior intimation to the receiving center using available communication
\nfacilities
\n\u2022 Arrange for an ambulance
\n\u2022 Transfer in a vehicle to Secondary Care Hospital or Tertiary Care Hospital
\nwhere mechanical ventilator and dialysis facilities are available
\nContinue life supporting measures
\n\u2022 Provide airway support with the help of an accompanying staff
\n\u2022 Send the referral note with details of treatment given
\n\u2022 Instruct one staff to accompany the patient during transportation if required.
\n\u2022 Hand over the referral form with details regarding treatment given
\n\u2022 Mention the clinical status clearly in the referral form at the time of referral.<\/p>\n","protected":false},"excerpt":{"rendered":"
The medical offi cer who is treating the cases of snake bite should take meticulous care to look in to the patient\u2019s status and provide fi rst aid as well as supportive measures before referring the case to higher centre \/ speciaslist. The details are furnished in Table 15 below. Table No. 15: Referral aspects […]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":21,"menu_order":7,"comment_status":"open","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-53","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/53","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=53"}],"version-history":[{"count":0,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/53\/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=53"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}