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    ATLS Fatmawati

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    Anindya Anjas Putriavi
    Snakebites remain a public health issue in Indonesia, with over 135,000 cases reported annually resulting in 50-100 deaths. There are over 370 snake species found in Indonesia, with 76 classified as venomous. Proper first aid and treatment is important to reduce mortality from snakebites. First aid involves keeping the airway open and applying pressure immobilization. Antivenom is the primary treatment for venomous bites, with the Indonesian antivenom (SABU) effective against the "Big 3" snake families. Symptomatic treatments may also be needed depending on the venom type and symptoms. Education on snake identification and proper wound care can help reduce risks from snakebites.

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    ATLS Fatmawati

    Uploaded by

    Anindya Anjas Putriavi
    71 views35 pages
    Snakebites remain a public health issue in Indonesia, with over 135,000 cases reported annually resulting in 50-100 deaths. There are over 370 snake species found in Indonesia, with 76 classified as venomous. Proper first aid and treatment is important to reduce mortality from snakebites. First aid involves keeping the airway open and applying pressure immobilization. Antivenom is the primary treatment for venomous bites, with the Indonesian antivenom (SABU) effective against the "Big 3" snake families. Symptomatic treatments may also be needed depending on the venom type and symptoms. Education on snake identification and proper wound care can help reduce risks from snakebites.

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    ATLS fatmawati

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    Snakebites remain a public health issue in Indonesia, with over 135,000 cases reported annually resulting in 50-100 deaths. There are over 370 snake species found in Indonesia, with 76 classified as venomous. Proper first aid and treatment is important to reduce mortality from snakebites. First aid involves keeping the airway open and applying pressure immobilization. Antivenom is the primary treatment for venomous bites, with the Indonesian antivenom (SABU) effective against the "Big 3" snake families. Symptomatic treatments may also be needed depending on the venom type and symptoms. Education on snake identification and proper wound care can help reduce risks from snakebites.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    71 views35 pages

    ATLS Fatmawati

    Uploaded by

    Anindya Anjas Putriavi
    Snakebites remain a public health issue in Indonesia, with over 135,000 cases reported annually resulting in 50-100 deaths. There are over 370 snake species found in Indonesia, with 76 classified as venomous. Proper first aid and treatment is important to reduce mortality from snakebites. First aid involves keeping the airway open and applying pressure immobilization. Antivenom is the primary treatment for venomous bites, with the Indonesian antivenom (SABU) effective against the "Big 3" snake families. Symptomatic treatments may also be needed depending on the venom type and symptoms. Education on snake identification and proper wound care can help reduce risks from snakebites.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 35

    Update manajemen

    snakebite
    BIODIVERSITY OF INDONESIAN SNAKE

    Wallacea

    Papua New
    Guinea
    Sundaland
    Snakebites data
     Data : 135.000/year incidence
     mortality over 50 -100 people per year
     Cases report in ITS : 500-1000 cases
    Snake families and general venom effects

    Venomous
    Snake
    families

    Elapidae Hydrophiidae Viperidae Colubridae

    Myotoxic Cytotoxic
    Neurotoxic Renal toxicity Myotoxic
    Coagulopathic
    (bungarus sp),calliophis Coagulopathic
    +cytotoxic in cobra &
    king cobra
    + coagulopathy in
    Australasian elapids
    Indonesia
    Total snake species :
    370
    Venomous snake
    species:
    • Elapidae: 55
    • Viperidae: 21
    • Colubridae: 1
    JAVA

    Calloselasma rhodostoma
    Trimeresurus puniceus Trimeresurus insularis
    Trimeresurus albolabris
    Laticauda colubrina

    Bungarus fasciatus Calliophis bivirgata


    Bungarus candidus Naja sputatrix Ophiophagus hannah

    • Viperidae 5
    • Elapidae 7
    • Hydrophidae 14
    Pictures of venomous snakes found in Irian
    Jaya

    Micropechis ikaheka Acanthophis laevis Pseudoechis


    papuanus

    Pseudonaja textilis Oxyuranus scutellatus Pseudoechis rossignolii


    Sea krait and sea snakes

    Sea krait Beaked sea snakes Spine-bellied sea snake


    Laticauda colubrina Hydrophis schistosa Hydrophis curtus
    Berbisa

    Tidak Berbisa
    Non venomous
    venomous
    First aid
    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
    Snake antivenom in Indonesia
    Snake Antivenom
    Monovalent Polyvalent
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    TREATMENT (3)

    • Anticholinesterase drugs
    • Especially for neurotoxin envenoming
    • Should give atropine before giving the drugs to prevent physostigmine
    intoxication.
    • Physostigmine dose
    • Adult (>12 yo) : 0,5-2,5 mgevery 1-3 hours up to 10 mg/24hours
    • Children ≤ 12 yo : 0.01 mg-0,04/kg
    • Should be given slowly 3-5 minutes by IV /IV/SC repeat 2-4 hours
    • Atropin inj bradikardia
    Neurotoksin(julian
    whie,2016)
    Haemotoxin system
    Venom oftalmia
    Mitos ,mistis
    20 wbct dan RPP alat penunjaang diagnose gigitan ular
    wound care snakebite
    dan rehabilitasi
    gigitan ular
    Death adder cases

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