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    1) Snake bites are a serious health issue in Indonesia, with hundreds of cases and dozens of deaths reported annually from venomous snakes like cobras, sea snakes, and vipers. 2) The most common symptoms of snake envenoming include pain and swelling at the bite site, nausea, vomiting, difficulty breathing, and bleeding. Left untreated it can lead to organ damage or death. 3) Treatment for snake bites in Indonesia involves first aid measures like immobilization, monitoring vital signs, analgesia, antibiotics if needed, and antivenom therapy. The antivenom used is called SABU and covers the most common deadly snakes in Indonesia.

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    1) Snake bites are a serious health issue in Indonesia, with hundreds of cases and dozens of deaths reported annually from venomous snakes like cobras, sea snakes, and vipers. 2) The most common symptoms of snake envenoming include pain and swelling at the bite site, nausea, vomiting, difficulty breathing, and bleeding. Left untreated it can lead to organ damage or death. 3) Treatment for snake bites in Indonesia involves first aid measures like immobilization, monitoring vital signs, analgesia, antibiotics if needed, and antivenom therapy. The antivenom used is called SABU and covers the most common deadly snakes in Indonesia.

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    17 views37 pages

    Snakebite Medan DR Dicky

    Uploaded by

    puskesmas papar
    1) Snake bites are a serious health issue in Indonesia, with hundreds of cases and dozens of deaths reported annually from venomous snakes like cobras, sea snakes, and vipers. 2) The most common symptoms of snake envenoming include pain and swelling at the bite site, nausea, vomiting, difficulty breathing, and bleeding. Left untreated it can lead to organ damage or death. 3) Treatment for snake bites in Indonesia involves first aid measures like immobilization, monitoring vital signs, analgesia, antibiotics if needed, and antivenom therapy. The antivenom used is called SABU and covers the most common deadly snakes in Indonesia.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pptx, pdf, or txt
    of 37

    Kematian akibat gigitan

    ular`
    Tri Maharani
    BIODIVERSITY OF INDONESIAN SNAKE

    Wallacea

    Papua New
    Guinea
    Sundaland
    Indonesia
    Total snake species : 349.
    Venomous snake species:

    Elapidae: 55
    Viperidae: 21
    Colubridae: 1
    Kasus Gigitan Ular di Indonesia 2020-2021
    (catatan Indonesia toxinology society)

    600

    500

    400

    300

    200

    100

    0
    elapid seasnake viper rhabdopis

    80%
    2020 2021

    70%
    Jumlah Kematian Akibat Gigitan Ular di Indonesia 2020-2021

    40

    35

    30

    25

    20

    15

    10

    0
    elapid seasnake viper rhadbophis

    2020 2021 80%

    70%
    Non venomous
    venomous
    Snake families and general venom
    effects
    Venomous
    Snake families

    Elapidae Hydrophiidae Viperidae Colubridae

    Myotoxic Cytotoxic Coagulopathic


    Renal toxicity Myotoxic
    Coagulopathic
    Neurotoxic
    +cytotoxic in cobra & king cobra
    + coagulopathy in Australasian elapids
    HUMAN LYMPHATIC DRAINAGE
    First aid
    Physical Examination
     Vital sign (BP, pulse, RR, temp)
     Pain score
     General examination
     Head and neck include ptosis
     Chest (lungs and heart)
     Stomach

     Upper and lower limb


     Localized examination
     Fang mark (do not mark the bite site!)
     Bleeding

     Necrotic tissues
     Bulae

     Etc.
    MONITORING

     Vital sign (BP, RR, Pulse, temp)


     Complain
     Pain score
     RPP test
     Bitten area evaluation
    TREATMENT (1)
    Keep the Airway Breathing and Circulation stable
    • Airway
    • 02 Non Re-Breathing Mask 12 lpm
    • Laryngeal Mask Airway and Endotracheal Tube (if needed)
    • Suction if gargling (+), Head tilt and chin lift if snoring (+)
    • Breathing
    • Evaluate the respiratory rate
    • Circulation
    • Make iv access, give Normal Saline 0.9% (don’t forget to take some blood for laboratory
    checking)
    • Blood pressure
    • Pulse
    • Oxygen saturation by using pulse oxymetri
    • Blood or Fresh Frozen Plasma as indicated
    TREATMENT (2)
    • Immobilize bitten area by using Pressure Bandaging Immobilization
    • Antivenom : DRUG OF CHOICE
    • If the snake that bite the patient include in 3 snakes which are covered by the
    SABU, we can give SABU quickly
    • 2 vials SABU + 500mml Normal saline 0.9% dripped 0-80 drop permminute
    hemotoxin bites
    • Repeated every 6 hours. BE AWARE TO RE-ENVENOMATION SIGN!!!
    • Symptomatic
    • Analgesia : morphine (PS≥7) and paracetamol infusion or oral (PS<7)
    • Antibiotic
    • When indicated, example : leucocytosis
    TREATMENT (3)

     Anticholinesterase drugs
     Especially for neurotoxin envenoming
     Should give atropine before giving the drugs to prevent physostigmine intoxication.
     Physostigmine dose
     Adult (>12 yo) : 1.0-2.0 mg
     Children ≤ 12 yo : 0.02 mg/kg/dose (max single dose 0.5 mg)
     Should be given slowly 3-5 minutes by IV push,repeat every 4 hour
    Venom oftalmia
    Neurotoksin(julian
    whie,2016)
    Haemotoxin system
    Snake antivenom in Indonesia
    SERUM ANTI BISA ULAR (SABU)

     SABU covers 3 venomous snakes


    1. Agkistrodon rhodostoma
    2. Naja sputatrix
    3. Bungarus fasciatus
    SNAKE ANTIVENOM

    MONOVALENT POLYVALENT
    Antivenom

     Equine Hyperimmune serum (IgG).


     Crude protein (Whole IgG).

     F(ab’)2.

     F ab.
     Low molecular weight.
     Decrease chance of hypersensitivity.
     Monovalent and Polyvalent antivenom
    Mitos ,mistis
    Klinik Heroku
    Sign and symptom


    haemoptoe

    Anuria → hematuria

    Gum bleeding

    General weakness

    Ptosis

    Decrease of consiousness

    Dyspneu ,respiratory failure
    Thailand antivenom daboi ruselli
    siamensis
    Doctor and nurse give antivenom qsmi
    thai
    terimakasih

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