SNAKEBITES
GROUP 6:
Canillas, Divino, Mantli
Pacete, Rudy, Selagpo
Utto
Table of contents
01 02 03
DEFINITION PATHOPHYSIOLOGY DIAGNOSTIC TEST
04 05
MANAGEMENT NURSING CARE PLAN
DEFINITION
Snakebite- a wound resulting from penetration of the flesh by
the fangs of a snake, especially a snake secreting venom
through or near the fangs.
The estimated annual snakebite incidence in the Philippines is
around 13,377 cases, with a 95% confidence interval of 11,452
- 15,772, and an estimated 550 deaths per year, based on a
decision analytic model; most of these bites are attributed to
the Philippine Cobra (Naja naja philippinensis) and limited data
exists on other species like the Samar Cobra (Naja samarensis)
which are also present in the country (Patikorn et al. 2022).
DEFINITION
Across the globe, between 4.5 and 5.4 million
people get bitten by snakes each year, with 81,000
to 138,000 dying from complications (WHO, 2019).
Children between 1 to 9 years of age are the most
likely victims. The greatest number of bites occurs
during the daylight hours and early evening of the
summer months.
PATHOPHYSIOLOG
Y
DIAGNOSTIC TEST
• 20-Minute Whole Blood Clotting Test (WBCT) – Quick bedside test to
assess coagulopathy.
• Prothrombin Time (PT)/International Normalized Ratio (INR) –
Evaluates blood clotting abnormalities.
• Serum electrolytes, Renal/Liver function test- Monitors organ function
and systemic involvement. (Na- 135-145mEq/L), K- 3.5-5.0 mEq/L),
Cl- 98-107 mEq/L), (HCO3- 22-28 mEq/L).
• (BUN- 7-20 mg/Dl), (Creatinine- 0.6-1.2 mg/Dl).
DIAGNOSTIC TEST
• Urinalysis- Detects hematuria and myoglobinuria.
• Enzyme-Linked Immunosorbent Assay (ELISA) –
This test detects specific venom antigens in the
blood, confirming the presence and type of snake
venom. It helps identify the snake species and
guides antivenom selection, but it is not widely
available in routine clinical settings.
MANAGEMENT;
• Ensure Airway, Breathing, Circulation (ABCs):
Secure airway, provide oxygen, establish IV access, manage shock if present.
• Control Venom Spread:
Keep the patient calm and still, immobilize the affected limb at heart level, remove
constrictive items.
• Administer Antivenom:
Indicated for progressive swelling, breathing difficulties, neurotoxic signs, or
coagulopathy.
Monitor for allergic reactions.
• Continuous Monitoring:
Vital signs, cardiac rhythm, neuro status, and swelling progression.
• Supportive Care:
IV fluids for hypotension, paracetamol for pain, tetanus prophylaxis if needed.
• Prepare for Complications:
Be ready to manage anaphylaxis (epinephrine), shock (fluids, vasopressors), or
respiratory failure (intubation).
MANAGEMENT;
The primary drug used to treat snakebites is antivenom (antivenin), which is
the only specific treatment that neutralizes snake venom. The choice of
antivenom depends on the type of snake and the region:
Polyvalent Antivenom:
Effective against bites from multiple species of venomous snakes.
Common in regions where identification of the specific snake is difficult.
Monovalent (Specific) Antivenom:
Targets venom from a specific snake species.
Used when the snake is identified (e.g., antivenom for cobra, viper, or
rattlesnake bites).
Needs Nursing
NURSING
Objective of
CARE PLAN
Nursing Actions with Rationale Evaluation
Data / Cues Diagnosis Care (@ least 5 nursing interventions)
Objective: P Ineffective Tissue Perfusion Within 30 Independent: ✅ Goal Met: After nursing interventions,
H related to venom induced minutes to ✔ Immobilize the affected limb and keep it the patient achieved vital signs of (BP >
BP:80/50 below heart level to slow venom absorption.
Y causing vascular damage, 100/80 mmHg, HR < 100 bpm, RR 16-20,
HR:112 S coagulopathy as evidence by 1 hour of Dependent: SpO₂ improves to ≥ 95%), improved
RR:28 I BP:80/50,HR:112,RR:28,Sp02:93 nursing ✔Administer Oxygen Therapy as ordered capillary refill time (<2 seconds), and
Sp02:93% %, prolonged Capillary refill time: interventio Provide nasal cannula (1–2 L/min) or face
O strong, palpable peripheral pulses. No
( >3 sec), Peripheral pulses: ns the mask (5–10 L/min) if SpO₂ continues to
Prolonged L signs of hypoperfusion (e.g., cold, clammy
(Weak, thready) decline.
Capillary O patient will ✔ Administer IV fluids (normal saline or skin, confusion) observed.
G lactated Ringer’s) to maintain circulation and ⚠ Goal Partially Met:
refill time: I Rationale achieve BP improves but remains slightly low
prevent hypovolemic shock.
( >3 sec) C Snake venom-induced vascular vital signs ✔ Administer antivenom as ordered to 90/60 mmHg, HR is reduced but still
Peripheral damage disrupts the integrity of of (BP > neutralize venom effects. elevated 105 bpm,SpO₂ improves at 94%
pulses: blood vessels and can cause both 100/80 ✔ Administer blood products (platelets, fresh but still below optimal, and capillary refill
Circula local tissue ischemia and frozen plasma) as ordered if needed time is still slightly delayed (>2
(Weak, systemic effects. The venom can mmHg, HR independent:
tion seconds)Peripheral pulses are weak but
thready) lead to coagulopathy (e.g., < 100 bpm, ✔ Monitor vital signs every 15–30 minutes to detectable, with signs of early shock cold,
disseminated intravascular RR 16-20, detect worsening hypotension. clammy skin, mild confusion.
coagulation or DIC), Sp02 95- ✔ Assess capillary refill, peripheral pulses,
depletingclotting factors and and skin temperature regularly. ❌ Goal Not Met:
causing uncontrolled bleeding or
100%) ✔️Assess for spontaneous bleeding (gums, ✘ BP remains critically low (<80/50
thrombosis, which impairs the and nose, urine, stool, IV sites)
mmHg), HR is elevated ( 112 bpm), and
normal flow of blood and oxygen improve Collaborative:
✔ Collaborate with medical technologist to RR is still high 28 cpm, SpO₂ decrease at
to tissues. capillary 90% despite interventions.Capillary refill
monitor coagulation profile (PT, aPTT, INR,
refill time fibrinogen, D-dimer) every 6 hours. remains prolonged (>3 seconds), and
(<2 peripheral pulses are absent and show
signs of shock persosit with cold, clammy
seconds).
skin, confusion.
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