Snake Bite Envenomation in Sangre Grande Hospital, Trinidad. Emergency Medicine Australasia

Abstract

Aims The Aim of this study was to review the incidence and presentations of snakebites at the Sangre Grande Hospital, a small district hospital in Trinidad. Methods This was a retrospective analysis of all snakebites admitted to the Sangre Grande Hospital from 1st January 2001–31st December 2002.The notes of all identified patients were checked to obtain demographic and clinical data regarding the incident, including demographic data on the patient, the type of snake, initial clinical features and the presence of complications. Results In all 29 patients were identified. The majority were young men between the ages of 15 and 30 years. The most common snake involved was the ‘mapipire’, and endemic tropical pit viper. Most patients suffered local symptoms, including swelling, blistering and tenderness over the affected area. Local complications included infection, necrosis of soft tissues and compartment syndrome. Only a small minority of patients received antivenom. The administration of antivenom did not appear to be related to the severity of symptoms. All patients were admitted to hospital. There were no deaths. None of the patients received intensive care for their envenomations. Conclusions Snakebites are relatively common in Trinidad. The hospital surveyed is situated in a rural area, surrounded by tropical rain forest. The majority of patients were young men, presumably forestry workers. As such, the bites are an occupational hazard.The use of antivenin was restricted to a minority of patients, and did not follow published guidelines on antivenin use, both in terms of indications for administration and dosage.The use of a set protocol, together with more ready availability of antivenom is needed in the setting described, to avoid long-term morbidity in patients presenting with snakebites