Epidemiology of snakebites from a general hospital in Singapore: a 5-year retrospective review (2004-2008)

This is a retrospective study on the epidemiology of snakebites that were presented to an emergency department (ED) between 2004 and 2008. Snakebite cases were identified from International Classification of Diseases (ICD) code E905 and E906, as well as cases referred for eye injury from snake spit...

Full description

Saved in:
Bibliographic Details
Published inAnnals of the Academy of Medicine, Singapore Vol. 39; no. 8; pp. 640 - 647
Main Author Tan, Hock Heng
Format Journal Article
LanguageEnglish
Published Singapore 01.08.2010
Subjects
Online AccessGet full text

Cover

Loading…
Abstract This is a retrospective study on the epidemiology of snakebites that were presented to an emergency department (ED) between 2004 and 2008. Snakebite cases were identified from International Classification of Diseases (ICD) code E905 and E906, as well as cases referred for eye injury from snake spit and records of antivenom use. Fifty-two cases were identified: 13 patients witnessed the snake biting or spitting at them, 22 patients had fang marks and/or clinical features of envenomations and a snake was seen and the remaining 17 patients did not see any snake but had fang marks suggestive of snakebite. Most of the patients were young (mean age 33) and male (83%). The three most commonly identified snakes were cobras (7), pythons (4) and vipers (3). One third of cases occurred during work. Half of the bites were on the upper limbs and about half were on the lower limbs. One patient was spat in the eye by a cobra. Most of the patients (83%) arrived at the ED within 4 hours of the bite. Pain and swelling were the most common presentations. There were no significant systemic effects reported. Two patients had infection and 5 patients had elevated creatine kinase (>600U/L). Two thirds of the patients were admitted. One patient received antivenom therapy and 5 patients had some form of surgical intervention, of which 2 had residual disability. One patient had heparin instilled in the eye for eye injury from cobra spit. Snakebite infrequently presents to the ED. Most of the patients developed local effects that do well with supportive treatment.
AbstractList This is a retrospective study on the epidemiology of snakebites that were presented to an emergency department (ED) between 2004 and 2008. Snakebite cases were identified from International Classification of Diseases (ICD) code E905 and E906, as well as cases referred for eye injury from snake spit and records of antivenom use. Fifty-two cases were identified: 13 patients witnessed the snake biting or spitting at them, 22 patients had fang marks and/or clinical features of envenomations and a snake was seen and the remaining 17 patients did not see any snake but had fang marks suggestive of snakebite. Most of the patients were young (mean age 33) and male (83%). The three most commonly identified snakes were cobras (7), pythons (4) and vipers (3). One third of cases occurred during work. Half of the bites were on the upper limbs and about half were on the lower limbs. One patient was spat in the eye by a cobra. Most of the patients (83%) arrived at the ED within 4 hours of the bite. Pain and swelling were the most common presentations. There were no significant systemic effects reported. Two patients had infection and 5 patients had elevated creatine kinase (>600U/L). Two thirds of the patients were admitted. One patient received antivenom therapy and 5 patients had some form of surgical intervention, of which 2 had residual disability. One patient had heparin instilled in the eye for eye injury from cobra spit. Snakebite infrequently presents to the ED. Most of the patients developed local effects that do well with supportive treatment.
Introduction: This is a retrospective study on the epidemiology of snakebites that were presented to an emergency department (ED) between 2004 and 2008. Materials and Methods: Snakebite cases were identified from International Classification of Diseases (ICD) code E905 and E906, as well as cases referred for eye injury from snake spit and records of antivenom use. Results: Fifty-two cases were identified: 13 patients witnessed the snake biting or spitting at them, 22 patients had fang marks and/or clinical features of envenomations and a snake was seen and the remaining 17 patients did not see any snake but had fang marks suggestive of snakebite. Most of the patients were young (mean age 33) and male (83%). The three most commonly identified snakes were cobras (7), pythons (4) and vipers (3). One third of cases occurred during work. Half of the bites were on the upper limbs and about half were on the lower limbs. One patient was spat in the eye by a cobra. Most of the patients (83%) arrived at the ED within 4 hours of the bite. Pain and swelling were the most common presentations. There were no significant systemic effects reported. Two patients had infection and 5 patients had elevated creatine kinase (>600U/L). Two thirds of the patients were admitted. One patient received antivenom therapy and 5 patients had some form of surgical intervention, of which 2 had residual disability. One patient had heparin instilled in the eye for eye injury from cobra spit. Conclusions: Snakebite infrequently presents to the ED. Most of the patients developed local effects that do well with supportive treatment. Key words: Antivenom, Cobra, Envenomomation, Spit, Viper
INTRODUCTIONThis is a retrospective study on the epidemiology of snakebites that were presented to an emergency department (ED) between 2004 and 2008. MATERIALS AND METHODSSnakebite cases were identified from International Classification of Diseases (ICD) code E905 and E906, as well as cases referred for eye injury from snake spit and records of antivenom use. RESULTSFifty-two cases were identified: 13 patients witnessed the snake biting or spitting at them, 22 patients had fang marks and/or clinical features of envenomations and a snake was seen and the remaining 17 patients did not see any snake but had fang marks suggestive of snakebite. Most of the patients were young (mean age 33) and male (83%). The three most commonly identified snakes were cobras (7), pythons (4) and vipers (3). One third of cases occurred during work. Half of the bites were on the upper limbs and about half were on the lower limbs. One patient was spat in the eye by a cobra. Most of the patients (83%) arrived at the ED within 4 hours of the bite. Pain and swelling were the most common presentations. There were no significant systemic effects reported. Two patients had infection and 5 patients had elevated creatine kinase (>600U/L). Two thirds of the patients were admitted. One patient received antivenom therapy and 5 patients had some form of surgical intervention, of which 2 had residual disability. One patient had heparin instilled in the eye for eye injury from cobra spit. CONCLUSIONSSnakebite infrequently presents to the ED. Most of the patients developed local effects that do well with supportive treatment.
Author Tan, Hock Heng
Author_xml – sequence: 1
  givenname: Hock Heng
  surname: Tan
  fullname: Tan, Hock Heng
  email: hock_heng_tan@cgh.com.sg
  organization: Department of Emergency Medicine, Changi General Hospital, Singapore. hock_heng_tan@cgh.com.sg
BackLink https://www.ncbi.nlm.nih.gov/pubmed/20838707$$D View this record in MEDLINE/PubMed
BookMark eNpNkMtOwzAQRS1UBC3wC8gSC2ARcGwndmCFqvKQKljw2EZOMi6GxA52CurfY1Go2MxDc2fu6EzQyDoLCB2l5IyLlNBzZa1qQ6Jq1XTQhMXZCyvuZZ9zsoXGhBGe8JzQ0b96F01CeCOEC0LzHbRLiWRSEDFGb7PeNNAZ17rFCjuNg1XvUJkBAtbedVjhBVjwqsWvLvRmiIWx-NHYheqdh4soyJIVKI89DD5KoB7MJ8Tu08AXPqHRNYlBnu6jbR3_hoPfvIeer2dP09tk_nBzN72aJzUTbEhSxpQsVCFYlmtGpWpkkTdKaM0ppRxyWdQ0A6mVqEgmWV1nPBeN1hVPSVFlbA8dr-_23n0sIQxlZ0INbassuGUoRZalokg5i8rLtbKOjwcPuuy96ZRflSkpf1iXa9blhnW5YR23D399llWcbXb_4LJv_I-BZg
CitedBy_id crossref_primary_10_1016_j_wem_2016_01_001
crossref_primary_10_18410_jebmh_2019_256
crossref_primary_10_11646_zootaxa_5287_1_1
crossref_primary_10_1016_j_wem_2014_10_007
crossref_primary_10_1097_GOX_0000000000003778
crossref_primary_10_3389_fphar_2022_816795
crossref_primary_10_1007_s12593_013_0102_6
crossref_primary_10_1177_0748233712472522
crossref_primary_10_7705_biomedica_v32i3_591
crossref_primary_10_1016_j_jprot_2019_103418
crossref_primary_10_1016_j_jflm_2016_01_013
crossref_primary_10_1155_2013_247645
crossref_primary_10_1016_j_ijmedinf_2023_105024
crossref_primary_10_1371_journal_pone_0229989
crossref_primary_10_1016_j_jemrpt_2024_100074
Cites_doi 10.1590/s0036-46651992000600002
10.1016/s1607-551x(08)70009-3
10.1081/clt-120028743
10.1580/08-weme-or-219.1
10.1016/j.toxicon.2005.02.010
10.5694/j.1326-5377.1996.tb122122.x
10.1016/0041-0101(95)00139-5
10.1007/bf02725623
10.1016/0035-9203(92)90463-m
10.1016/b978-044481557-6/50035-6
10.1371/journal.pmed.0050218
10.1067/mem.2001.113373
10.1580/07-weme-ed-099r.1
10.1016/j.jpedsurg.2007.11.011
10.1080/15563650600584451
10.47102/annals-acadmedsg.V34N5p356
10.1580/06-weme-co-023r1.1
ContentType Journal Article
DBID CGR
CUY
CVF
ECM
EIF
NPM
AAYXX
CITATION
7X8
DOI 10.47102/annals-acadmedsg.V39N8p640
DatabaseName Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
CrossRef
MEDLINE - Academic
DatabaseTitle MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
CrossRef
MEDLINE - Academic
DatabaseTitleList MEDLINE
CrossRef
MEDLINE - Academic
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: EIF
  name: MEDLINE
  url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search
  sourceTypes: Index Database
DeliveryMethod fulltext_linktorsrc
Discipline Medicine
EISSN 0304-4602
EndPage 647
ExternalDocumentID 10_47102_annals_acadmedsg_V39N8p640
20838707
Genre Journal Article
GeographicLocations Singapore
GeographicLocations_xml – name: Singapore
GroupedDBID ---
.GJ
2WC
53G
ABDBF
ACGFO
ALMA_UNASSIGNED_HOLDINGS
CGR
CUY
CVF
ECM
EIF
F5P
GROUPED_DOAJ
GX1
NPM
OK1
P2P
P6G
SJN
TR2
AAYXX
CITATION
7X8
ID FETCH-LOGICAL-c373t-133a89a97356f328ad896da7ff42224e689c25e8fa7b0583cc5467dffb4109b53
ISSN 0304-4602
IngestDate Fri Jun 28 16:17:46 EDT 2024
Fri Dec 06 03:53:59 EST 2024
Thu May 23 23:15:29 EDT 2024
IsDoiOpenAccess false
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Issue 8
Language English
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-c373t-133a89a97356f328ad896da7ff42224e689c25e8fa7b0583cc5467dffb4109b53
Notes ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
OpenAccessLink https://doi.org/10.47102/annals-acadmedsg.v39n8p640
PMID 20838707
PQID 755179143
PQPubID 23479
PageCount 8
ParticipantIDs proquest_miscellaneous_755179143
crossref_primary_10_47102_annals_acadmedsg_V39N8p640
pubmed_primary_20838707
PublicationCentury 2000
PublicationDate 2010-08-01
PublicationDateYYYYMMDD 2010-08-01
PublicationDate_xml – month: 08
  year: 2010
  text: 2010-08-01
  day: 01
PublicationDecade 2010
PublicationPlace Singapore
PublicationPlace_xml – name: Singapore
PublicationTitle Annals of the Academy of Medicine, Singapore
PublicationTitleAlternate Ann Acad Med Singapore
PublicationYear 2010
References ref13
ref12
ref15
ref14
ref11
ref10
ref0
ref2
ref1
ref17
ref16
ref19
ref18
ref24
ref23
ref26
ref25
ref20
ref22
ref21
ref28
ref27
ref8
ref7
ref9
ref4
ref3
ref6
ref5
References_xml – ident: ref1
– ident: ref3
– ident: ref18
  doi: 10.1590/s0036-46651992000600002
– ident: ref20
– ident: ref11
  doi: 10.1016/s1607-551x(08)70009-3
– ident: ref22
– ident: ref16
  doi: 10.1081/clt-120028743
– ident: ref7
  doi: 10.1580/08-weme-or-219.1
– ident: ref23
  doi: 10.1016/j.toxicon.2005.02.010
– ident: ref17
  doi: 10.5694/j.1326-5377.1996.tb122122.x
– ident: ref13
  doi: 10.1016/0041-0101(95)00139-5
– ident: ref26
  doi: 10.1007/bf02725623
– ident: ref5
  doi: 10.1016/0035-9203(92)90463-m
– ident: ref15
– ident: ref0
  doi: 10.1016/b978-044481557-6/50035-6
– ident: ref2
  doi: 10.1371/journal.pmed.0050218
– ident: ref4
– ident: ref25
  doi: 10.1067/mem.2001.113373
– ident: ref6
– ident: ref21
  doi: 10.1580/07-weme-ed-099r.1
– ident: ref19
  doi: 10.1016/j.jpedsurg.2007.11.011
– ident: ref24
  doi: 10.1080/15563650600584451
– ident: ref27
  doi: 10.47102/annals-acadmedsg.V34N5p356
– ident: ref28
– ident: ref9
  doi: 10.1580/06-weme-co-023r1.1
– ident: ref8
– ident: ref10
– ident: ref12
– ident: ref14
SSID ssj0047026
Score 2.0145323
Snippet This is a retrospective study on the epidemiology of snakebites that were presented to an emergency department (ED) between 2004 and 2008. Snakebite cases were...
Introduction: This is a retrospective study on the epidemiology of snakebites that were presented to an emergency department (ED) between 2004 and 2008....
INTRODUCTIONThis is a retrospective study on the epidemiology of snakebites that were presented to an emergency department (ED) between 2004 and 2008....
SourceID proquest
crossref
pubmed
SourceType Aggregation Database
Index Database
StartPage 640
SubjectTerms Adolescent
Adult
Aged
Animals
Antivenins - therapeutic use
Elapidae
Female
Hospitals, General - statistics & numerical data
Humans
Male
Middle Aged
Retrospective Studies
Saliva
Singapore - epidemiology
Snake Bites - drug therapy
Snake Bites - epidemiology
Time Factors
Treatment Outcome
Young Adult
Title Epidemiology of snakebites from a general hospital in Singapore: a 5-year retrospective review (2004-2008)
URI https://www.ncbi.nlm.nih.gov/pubmed/20838707
https://search.proquest.com/docview/755179143
Volume 39
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELaWIlVcKt4sL1mCAxxSsvEz3FaosEJqD7RFe4ucxEYFKbtqs4dy538zfiYtrVR6iVbe1Tj2zM7LM58ReisVz1sFkWrTSJbRRreZNJxmTa4kgy9pYWy-Y_-AL47p1yVbTiZ_RlVLm77ebX5f2VdyG67CGPDVdsn-B2cTURiAz8BfeAKH4XkjHu8N17u6g_LDTv3S9YlNpbq2kXlElU7Xg9j0xqG9BXtt62tdVzrLzi2Yzzfdn65i32XE2wf309WQ2PKFmDP4B3nZNacMjSn74bTe5VXjVEOCwGm5BWhhsHjBaoakw6jkLTVbwdyU516R6ivGgnL1SEVBiORIU3KP0hSMLvewm5f1ObX-j0cyhiVlCtYCPsLZj93vpDyQ60RjjKJ9ybqlmkOIdhy5yhOrErEqEbuD7lo8RXsFw5dlqhSiIi_8kXdY3zZ6E9_tw_VvdtHRuSZ6cV7M0X20E8IPPPey9ABNdPcQbUeWPUI_xyKFVwYPIoWtSOE5DiKFo0jhkw4nPn-EH3iBwhcECnuBwu-SOL1_jI4_7x19WmThOo6sIYL02YwQJUtVCsK4IYVUrSx5q4QxNo1INZdlUzAtjRJ1ziRpGgZWuDWmprO8rBl5gra6VaefIWxq0RClZjMiDLVnzVzUNvI1CvxJUBJTROPeVWuPulLdgH9ThOM-V6Al7dGX6vRqc1YJZqHoIDaYoqd-_xPdAoIQMFri-e3mfIHuDX-Ql2irP93oV-Cn9vVrJ0V_Aa9zkbY
link.rule.ids 314,780,784,27924,27925
linkProvider Geneva Foundation for Medical Education and Research
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Epidemiology+of+Snakebites+from+A+General+Hospital+in+Singapore%3A+A+5-year+Retrospective+Review+%282004-2008%29&rft.jtitle=Annals+of+the+Academy+of+Medicine%2C+Singapore&rft.au=Tan%2C+Hock+Heng&rft.date=2010-08-01&rft.issn=0304-4602&rft.eissn=0304-4602&rft.volume=39&rft.issue=8&rft.spage=640&rft.epage=647&rft_id=info:doi/10.47102%2Fannals-acadmedsg.V39N8p640&rft.externalDBID=n%2Fa&rft.externalDocID=10_47102_annals_acadmedsg_V39N8p640
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0304-4602&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0304-4602&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0304-4602&client=summon