Question of the Week

Question :
Posted On : 09 May 2016
what is the method of testing antisnake vaccines.some consulsant says we should strat ASV without testing as we have no choice,.we can stop it if ant reaction appear.
Expert Answer :
As per Serum Institute of India {manufacturer} for fast effect, the Anti Snkae Venom Serum should be injected intravenously as soon as possible after the bite. As a first dose, at least 20 ml. of the reconstituted serum should be injected intravenously very gradually {for every 1 ml per minute}.

The second dose should be repeated two hours after the first dose or even earlier. If the symptoms persist. If the symptoms, which vary with different snake venoms, indicate persistence of venom action, further doses should be repeated aftr every six hours until the symptoms disappear completely.

In case of Viper bite, some of Anti Snake Venom Serum should also be injected around the site of the snake bite additionally to prevent gangrene which is one of the more distructive effects of localised Viper Venom on tissue.
Intravenous injection of a reconstituted Anti Snake Venom Serum in equine serum sensitive subjects can produce very severe serum reactions and even acute anaphylaxis.

The sensitivity of the patient to Anti-Snake Venom Serum is tested by injecting subcutaneously 0.1 ml of this serum diluted 1:10. The patient should be observed for 30 minutes for local and general reactions. If the test dose shows either local reaction such as flare or general anaphylactic reaction such as pallor, sweating, nausea, vomiting, urticaria, and fall of blood pressure, these should be countered immediately by intramuscular injection of 1 ml of 1:1000 Adrenaline and with corticosteroids which should be always kept handy.
In allergic or sensitive patients, it is better to inject the Anti-Snake Venom Serum under cover of anti-histaminics such as antistine {100 mg.} and Hydrocortisone {100 mg.} intramuscularly 15 to 30 minutes before the administration of Anti-Snake Venom Serum. The administration of Adrenaline and Hydrocortisone may be repeated if necessary.
When symptoms of snakebite are severe it may not be advisable to wait for 30 minutes to observe reactions to test-dose of serum. In such cases it may be better to inject 1 ml. of 1:1000 Adrenaline intramuscularly at the same time as the serum in order to lessen the risk of anaphylaxis. Half the dose of Adrenaline may be repeated 15 minutes later if necessary.
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