Snake bite review

January 18, 2010, 3:43 pm

★★★☆☆

Snake bite. Warrell DA Lancet 2 Jan 2010;375:77-88.

Abstract

Snake bites have a larger impact on health than often realized. A calculated total of 30,000 to 40,000 deaths a year from snake bite is almost certainly an underestimation.  Snake venoms are complex mixes of bioactive chemicals that affect primarily the cardiovascular, hematologic, and neurological systems, as well as causing local tissue damage that can be extreme.  More study needs to be done on the effects of first-aid measures and use of specific antivenoms.Although this review article is intermittently interesting, it is so general and unfocused that not much usual clinical pearls can be snatched from it.  The main theme seems to be that preventive measures — wearing protective boots or sleeping of the ground in endemic areas — are the best bet for decreasing serious morbidity or mortality.

By the way, a commonly used  mnemonic to identify poison snakes depends on the color-band pattern, and goes: “Red on yellow, kill a fellow; red on black, poison lack”.  Unfortunately, this mnemonic is only good in North America — below the equator, things get complicated. Also, the mnemonic assumes a certain proximity to the snake which may not be advisable.  TPR has his own mnemonic, which has served him well in his world travels: “Red on yellow, run like hell!; red on black, run like hell!”

 

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