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Indian Pediatr 2010;47: 983 |
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Anti Snake Venom in Neonate with Snakebite |
Amit Devgan and M Kanitkar,
Department of Pediatrics, Armed Forces Medical College,
Pune 411 040,
Maharashtra, India.
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It was interesting to read the case report of a neonate with snakebite(1).
Attention of the authors is drawn towards an editorial published in
Indian Pediatrics on the management of Snakebite: The National
Protocol";(2). We must adhere to the National protocol irrespective of the
age of the child. In the case reported the child probably needed less than
half of the ASV administered, and airway management. The calculated dose
of ASV is to be administered over hour. Mechanical ventilation played a
bigger role than ASV in the good outcome of the case reported. Once snake
venom is bound to neuromuscular junction it cannot be detached by ASV. ASV
only neutralizes the circulating venom. The child in most likelihood
suffered a krait bite (night time bite) and its venom being presynaptic
was even less likely to be reversed by ASV as the presynaptic vesicles
once destroyed take 3-5 days to regenerate. It would be prudent to adhere
to National protocols, so as to conserve a scarce resource like ASV.
References
1. Jindal G, Mahajan V, Parmar VR. Anti snake venom in
a neonate with snakebite. Indian Pediatr 2010; 47: 349-350.
2. Simpson ID. The pediatric management of snakebite: The national
protocol. Indian Pediatr 2007; 44: 173-175.
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