Rawalpindi Medical College Hosts Snakebite Managment Meeting

On Ist March 2008, at Holy Family Hospital, Rawalpindi, Punjab hosted an introductory workshop on the new Snakebite Management Protocol issued by the Pakistan Medical Research Council and the Federal Health Department Islamabad.

The Workshop was presented by Ian Simpson an international snakebite expert and Snakebite Adviser to the Pakistan Medical Research Council, and Dr Amir Mahmood from AMSON.

AMSON Vaccines and Pharma Pvt (Ltd) in Islamabad have adopted snakebite as a corporate social responsibility programme and have committed to provide ‘train the trainer’ workshops in how to use the protocol to doctors across Pakistan. Each workshop will be supported by a training CD and handbook that will equip doctors to cascade the training to doctors in their district and Province. Today’s meeting was the first in a series of presentations and workshops which AMSON are carrying out on snakebite management designed to give practical guidance on snakebite management.

The object of the protocol is to ensure that doctors in Pakistan are given  the latest techniques in how to manage snakebite, particularly in areas such as North West Frontier Province where health facilities are widely dispersed and travel, particularly in the remote tribal areas is difficult. It is particularly important that doctors in remote settings are both   confident to treat snakebite and equipped so to do. Medical education relies on western textbooks which have little relevance in a rural Pakistan setting. Consequently doctors tend to refer patients directly to advanced institutions like Khyber Medical University and do not treat locally.

The journey places the victims at risk when they could be easily given anti snake venom at the local Rural Health Center or Basic Health Unit. In addition, many non envenomed victims are sent to advanced centers when they can be dealt with locally and avoid the journey altogether.

Supplies of anti snake venom are precious and doctors need to be given clear criteria as to when to give anti venom, how much to give, when repeat doses are required and when to stop giving ASV. If such criteria are not available anti venom is given to victims who are not in fact envenomed or too much is given to victims when the venom has already been neutralized.

These criteria are provided in the Protocol as is key guidance on managing neurotoxic snakebites in a rural setting and how to provide airway support, including readily improvisable equipment that can be used in a basic hospital or health facility.

Institutions like Rawalpindi Medical College can provide key assistance in establishing which are the medically significant snake species, in Punjab, by preserving dead snakes brought to the hospital for accurate identification.