Snake bite

Clinical feature:Pain at the site of the bite,nausea,vomiting,profuse sweating, thirst and collapse. There may be local redness Swelling  and extravasations of blood.
Treatment:
A. General measures:
1. Immobilise the patient and apply tourniquet proximal to the site of bite and suck out venom (after incision if needed) instantly.
2.The site of the bite should be cleaned and then left strictly alone; otherwise the danger of infection is increased. If skin necrosis occurs, sloughs should be excised (with skin grafts applied as suitable if possible)
 3. Hospitalization (specially in young children) whenever possible.
4. Maintain B.P by I.V fluid &blood transfusion if needed.
5. Sedatives are needed if the patient is apprehensive.
6. Appropriate antitetanus prophylaxis should be given taking account of the patient’s immune state
Specific management:
1. If there is a clear proof of systemic poisoning, antivenom should be given in advance stage. several local affects particularly necrosis may be avoided or minimized if antivenom can be given within 4 hours of bite.
Depending on the severity of poising,20-100ml antivenom is diluted in 2-3 volumes of isotonic  saline. This is then given by slow intravenous infusion (15 drops per minut)
2. Adrenaline (1:1000 solution) must be instantly available. If a reaction occurs the drip is stopped temporarily and 0.5 ml adrenaline is given at the first sign of anaphylaxis, it is speedily effective and the drip can be restarted with care. Several injections of adrenaline may specify.
3. Antihistaminic drug may be given i.v previous to the antivenom injection is started.
4. For children over 10 years and adults with no symptoms 2 hours after the bite-rest and antihistaminic drug is advisable