CANNING SUBDIVISIONAL HOSPITAL 24-PARAGANAS( S), W.B. Dr. Dayal Bandhu Majumdar www.kalachkrait.webs.com Number of snake bites in 2012. Total Number : 1225. Non Venomous Bites : 1157. Venomous Bites : 68. Neurotoxic Bites : 65. Hemotoxic Bites: 3. Number of Deaths : 10. TREATMENT PROTOCOL Status of the HOSPITAL 2nd tier Govt. Hospital. Number of M.Os: 22. All the M.Os are treating S.Bite Cases. No ICU or ITU. No Mechanical Ventilator. No Dialysis unit. Blood Bank for Whole Blood only. No. Laboratory for 24 hrs coverage. TREATMENT POLICY By Syndromic approach only. Snakes brought to Hospital: 30 only ( out of 1225 bites). Vast individual variation on ASV Dosage. Transferred to Kolkata for Mechanical Ventilation only. 10 patients died before transfer. Cause of Deaths Total Deaths ( in 2012) : 10. Respiratory failure in all cases. 7 due to terminal stage reporting. 3 ( ? ) Due to ASV failure; all Krait bites. ASV Brand USED Free Supply from State Govt. Central Store. Manufacturers : 1) Biological E. 2) VINS. 3) Bharat Serum. ASV REACTION Reaction in 3 cases only ( in 68). No Death from Reaction. One Bronchospasm. Two Urticarial Rashes . Preventive Adrenaline not used. Reaction Managed without Inj. Adrenaline. AREA COVERED 8 Blocks of the Sunderban Area. Population covered : 2 Million. Mostly Primary cases. Referred cases from Primary Health Centers also. Door to Door Survey revealed 23% Hospital attendance only. COMMON KRAIT Mysterious C. Krait 80% of the Venomous S. Bites. 100% in the Floor Bed ( in Night). 95% Presented with Pain Abdomen. Other Symptoms: Vomiting, fainting Attack, Arthalgia. Hemiperesis or quadriperesis. No H/O Bite in many cases. All had Bilateral ptosis in different times. Exceptions Very few Russell’s Viper in the area. No Spectale Cobra ( Naja Naja). All Cobras are Naja Kauthia. Plenty of Common Kraits(Bungarus caeruleus). No Banded Krait ( Bungarus Fasciatus). No Sawscled Vipers. GREEN PIT VIPERS Present only in the islands of Sunderbans. Practically non-venomous. Causes local swellings only. www.kalachkrait.webs.com