Tourniquets, incision suction harmful in snakebites:experts

Kochi, Jul 26 (UNI) Describing as ''extremely harmful'' common practices such as tourniquets or incision suction used by people for snakebite treatment, the draft National Protocol on snakebite management says that the best thing is to immobilise the bitten limb and rush the patient to hospital.

Talking to UNI about the highlights of the protocol, which was finalised during the two-day national conference 'TOXOCON-2', which concluded here last evening, conference organising secretary V V Pillay said that there were no documented studies available to show that tying of tourniquets or suction of venom were effective methods to treat snakebites.

''On the other hand, it is well documented that these methods do not work and result in a lot of harm, leading to high levels of mortality and morbidity due to snakebites in India. While tying tourniquets has been seen to lead to gangarene, efforts to suck out venom, especially through the mouth or other suction devices, can cause infection,'' Dr Pillay, who heads the Poison Control Centre at the Amrita Institute of Medical Sciences (AIMS) here, said.

Application of ice, another common practice, is also not useful and can lead to necrosis of the tissue, he added.

Dr Pillay said that the best thing to do in case of snakebite is to immobilise the affected limb with a splint to minimise its movement and then rush the victim to hospital.

While paracetamol can be administered to minimise pain, asprin should not be given as it can cause bleeding.

Once in hospital, the patient should be kept under observation for at least 24 hours. Anti-venom should be administered only if symptoms of envenomation such as swelling, bleeding from the wound or bleeding from gums and drooping of eyelids surface. This is necessary as not all snakes are venomous. Also sometimes a venomous snake may also have caused only a ''dry bite'', in which case there will be no envenomation.

''It is seen that there is needless administration of anti-venom in hospitals. This results not only in wastage of anti-venom, which is quite expensive, but can cause more damage as anti-venom can have severe side-effects,'' Dr Pillay said.

The two-day conference was jointly organised by the World Health Organisation (WHO) alongwith AIMS.

Dr Ian Simpson of the WHO Treatment Group on Snakebites said that the world health body was very concerned about the large number of snakebite deaths in India, estimated to be around 50,000 per annum.

''We wanted to study the situation on the ground that is causing this high mortality and suggest measures to rectify it,'' Mr Simpson said.

He described the draft protocol, drawn up by 40 experts from all over the country, guided by Dr Robert Norris of the Stanford School of Medicine, as an ''important step forward''.

The protocol will now be forwarded to the union health ministry and the WHO for ratification.

Consisting of two major sections -- a first aid protocol and a hospital management protocol -- the draft protocol lists the guidelines and do's and don'ts to build awareness in the community as well as among doctors.

''In fact, this is the first time in the world that a uniform, standardised protocol is being drawn up for an entire country. But, in India, this is the need of the hour,'' Mr Simpson added.

UNI ARC DK1346