International Snakebite Awareness Day: Quiz!

After any snake bite incident, it is crucial to send the victim to the hospital immediately. Snake bites can be life-threatening, and prompt medical attention is necessary to administer the appropriate antivenom and provide other necessary treatments. Delaying medical care can lead to complications and worsen the victim's condition. Therefore, immediate hospitalization is essential to ensure the victim's safety and increase their chances of recovery.

Neurotoxic snake venom affects the nervous system, particularly the muscles and nerves responsible for breathing. This can lead to respiratory failure, where the person is unable to breathe adequately on their own. Excessive fear, acute kidney injury, and limb paralysis may be symptoms or consequences of a neurotoxic snake bite, but the primary mode of death is respiratory failure.

Village people are mostly affected by snake bites because they are more likely to come into contact with snakes due to their proximity to natural habitats. In rural areas, people often engage in agricultural activities or live in close proximity to forests or farmlands, increasing their chances of encountering snakes. Additionally, access to healthcare facilities and antivenom may be limited in rural areas, further exacerbating the impact of snake bites on village communities.

Pressure immobilization is the recommended first aid in managing snake bites. This involves applying a firm bandage over the bitten area, followed by immobilizing the affected limb with a splint or sling. Pressure immobilization helps to restrict the movement of venom through the lymphatic system, reducing its spread to other parts of the body. It also helps to minimize the absorption of venom into the bloodstream, providing temporary relief and preventing further complications. This technique should be used until medical help is obtained, as it can help buy time and potentially save a person's life.

Polyvalent antivenom is the correct answer because it is a type of antivenom that is effective against multiple types of snake venom, including Russel's viper venom. This makes it a suitable option for managing Russel's viper bites in Bangladesh, where Russel's vipers are found. Monovalent antivenom against Russel's viper would only be effective against that specific type of snake venom, while bi-valent antivenom against Russel's viper would be effective against two types of snake venom, but not necessarily Russel's viper venom.

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The correct answer is 10 because a snakebite typically requires the administration of 10 vials of Polyvalent antivenom. This is because snake venom can be highly potent and can cause severe symptoms, so a sufficient amount of antivenom is needed to neutralize the venom and prevent further harm to the victim.

The correct answer is "None of the above." This means that antivenom treatment is not contraindicated for pregnant women, patients with chronic kidney diseases, or patients with a history of allergic reactions to drugs. In other words, antivenom treatment can be used for these patients without any concerns or restrictions.

The statement "No scientific evidence" suggests that there is no scientific research or studies to support the claim that carbolic acid can be used to distract a snake. This means that there is no reliable or credible information to prove that carbolic acid is effective in distracting snakes. Therefore, the use of carbolic acid for this purpose is not supported by scientific evidence.

The correct answer is "Stop whenever neurological features disappear." This means that the additional treatment with Neostigmine and Atropine should be continued until the neurological features, such as muscle weakness or paralysis, disappear. Once these symptoms have resolved, there is no longer a need to continue the treatment.

The available polyvalent antivenom does not contain the antivenom against the Green pit snake. This means that if someone is bitten by a Green pit snake, the polyvalent antivenom would not be effective in treating the snakebite. It is important to have specific antivenom for each type of snake as different snake venoms have different compositions and effects on the body.

After successfully managing an antivenom reaction, it is recommended to reintroduce the antivenom. This is because the initial reaction may have been due to a specific sensitivity or allergic response, and reintroducing the antivenom can help determine if the reaction was a one-time occurrence or if it will happen again. Reintroduction should be done under close medical supervision to monitor for any adverse effects.

The syndromic approach is commonly used to detect the offending snake in Bangladesh. This method involves identifying the symptoms and signs exhibited by the victim and matching them with known characteristics of snakebite envenomation. By using this approach, healthcare professionals can make an initial assessment and provide appropriate treatment without the need for specific laboratory tests. This method is particularly useful in resource-limited settings where access to advanced diagnostic tools like ELISA or PCR may be limited.

International Snake Bite Awareness Day is observed on 19 September. This day is dedicated to raising awareness about the dangers of snake bites and promoting measures to prevent and treat them. Snake bites are a significant public health issue in many parts of the world, particularly in rural areas where access to medical care may be limited. By observing this day, organizations and individuals aim to educate people about snake bite prevention, first aid, and the importance of seeking prompt medical attention in case of a snake bite.

The correct answer is 623/100000. This indicates that the estimated annual incidence of snake bites in Bangladesh is 623 cases per 100,000 population. This suggests that snake bites are relatively common in Bangladesh, with a significant number of cases occurring each year.

The National Venom Research Center is situated in Chittagong.

The correct answer is 6000. This suggests that there are approximately 6000 deaths each year in Bangladesh as a result of snake bites. This high number indicates that snake bites are a significant cause of mortality in the country. It is important for authorities to address this issue and implement measures to prevent and treat snake bites in order to reduce the number of deaths.

Russel's viper is the correct answer because it is known to have venom that contains coagulants, which can result in whole blood clotting. The other snakes listed, such as the Cobra, Krait, and Sea snake, do not typically have venom that causes whole blood clotting.

After administering the first dose of Polyvalent antivenom for Cobra, the second dose should be repeated after 60 minutes. This is because the effects of the antivenom may wear off after some time, and it is important to maintain a sufficient level of antivenom in the body to counteract the venom's effects. Waiting for 60 minutes ensures that the antivenom is still effective and provides continued protection against the Cobra's venom.

Endotracheal intubation is the correct first step of management in a patient with reduced respiratory effort and low PaO2 following a cobra bite. Intubation is necessary to secure the patient's airway and ensure adequate oxygenation and ventilation. This intervention allows for the delivery of supplemental oxygen and the ability to assist or control the patient's breathing if necessary. Immediate administration of antivenom, administration of atropine and neostigmine, and prophylactic subcutaneous adrenaline may be indicated in the management of a cobra bite, but securing the airway takes priority in this scenario.

The krait snake does not cause features of local envenomation. Local envenomation refers to the symptoms and effects that occur at the site of the snakebite, such as swelling, pain, and tissue damage. While cobras, Russel's vipers, and green pit vipers can all cause local envenomation, the krait snake does not typically cause these local effects. Instead, it primarily causes systemic effects such as muscle paralysis and respiratory failure.

Subcutaneous (S/C) administration of Adrenalin is recommended to prevent antivenom reaction. Adrenalin, also known as epinephrine, is a medication that helps counteract severe allergic reactions, including those caused by antivenom. By administering it subcutaneously, the drug can quickly enter the bloodstream and work to alleviate symptoms such as swelling, difficulty breathing, and low blood pressure associated with an allergic reaction to antivenom.

Neostigmine is not used to treat Antivenom reactions. Antivenom reactions are allergic reactions that occur in response to the administration of antivenom. Adrenalin, anti-histamines, and hydro-cortisone are commonly used to treat these reactions by reducing inflammation, alleviating itching, and stabilizing blood pressure. However, Neostigmine is not effective in treating allergic reactions and is primarily used for other medical conditions such as myasthenia gravis.

Based on the given information, the patient presented with bilateral ptosis (drooping of the eyelids) and painful swelling at the bite site. These symptoms are consistent with a cobra snakebite. Cobras are known to cause neurotoxic effects, including ptosis, due to the venom they inject. Additionally, the 20 minutes whole blood clotting test being less than 20 minutes suggests the presence of coagulopathy, which is commonly seen in cobra envenomation. Therefore, the offending snake in this case is likely a cobra.

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Based on the symptoms described, the suspected snake in this case is the Russel's viper. The blood-stained blister and bilateral ptosis (drooping of the eyelids) are characteristic symptoms of a Russel's viper bite. Cobras, green pit vipers, and kraits do not typically cause these specific symptoms.

Ophiophagus Hannah, also known as the king cobra, does not cause procoagulant coagulopathy. This means that it does not induce a condition where blood coagulation is enhanced, leading to abnormal clotting. While the king cobra can cause flaccid paralysis, local necrosis, and shock, it does not have the ability to trigger procoagulant coagulopathy.

Kraits do not cause procoagulant coagulopathy. Procoagulant coagulopathy is a condition where the blood's ability to clot is impaired, leading to excessive bleeding. While green pit vipers, Russel's vipers, and cobras are known to cause procoagulant coagulopathy, kraits do not have this effect. Kraits are venomous snakes found in South Asia, and their venom primarily affects the nervous system, causing paralysis and respiratory failure.

The krait is a neurotoxic snake, meaning it produces toxins that affect the nervous system. This makes it highly dangerous to humans and other animals. Kraits are found in various parts of Asia and are known for their venomous bites. They are nocturnal snakes and are often found hiding in dark, secluded areas. Kraits have a distinctive appearance, with a black body and white or yellow bands. Due to their potent venom and aggressive nature, kraits are considered one of the most deadly snake species in the world.

Neostigmine and atropine are not recommended as additional treatments for snake bites from the green pit viper. This is because the venom of the green pit viper does not typically cause the same systemic effects as the venom of other venomous snakes like the cobra, krait, and Russel's viper. Neostigmine and atropine are commonly used in the management of snake bites to counteract the effects of neurotoxic venoms, but they may not be necessary in the case of a green pit viper bite.