Potosis, Conjunctival congestion & altered sensorium after an alleged history of snakebite

A 28 y/o male patient presented with altered sensorium with an alleged history of snakebite. The patient was brought to the hospital within 3 h of snakebite. Patient was conscious but irritable moving all four limbs spontaneously. He had hematemesis, hematuria, and bleeding from the bite site. Both his conjunctiva appeared congested. Ptosis was evidently seen. Vitals: 102/min, regular, BP 90/60 mmHg, SpO2 – 99% at room air, Glucometer RBS 84 mg/dL, and temperature – 98.4°F. His Glasgow coma scale was 15. How to treat this patient?


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This patient had snake bite the hours back First question is was the snake poisonous? Is there any evidence of envenomation? And answer is yes, it was poisonous snake and there is evidence of envenomation in form of bleeding and ptosis. Next question - was the snake from elapidae family - neurotoxic variety or viperidae family - vasculotoxic variety This envenomation appears to be mixed variety because of bleeding and neurological features such as ptosis Therefore, polyvalent anti snake venom need to be administered, it should be administered as early as possible si that it can neutralise maximum amount of venom in our body This appears to be a case of moderate envenomation - thus 5 - 10 vials of anti snake venom may need to be administered This patient's MRI shows intracerebral bleed in right parieto-occipital region It is suggestive of vasculotoxic venom causing bleeding - PT, PTT and INR need to be checked and fresh frozen plasma need to be administered to correct bleeding disorder This patient has ptosis, which is suggestive of neurotoxic envenomation. It may progress to cause bulbar palsy and breathing difficulty This patient need to be admitted in ICU with facility of intubation and ventilation to be kept on stand by. Acetylcholine esterase inhibitor can be used to reverse neurotoxic effect of venom.
MRI T1 hyperintense lesion rt parietal with perilesional edema with blood in the posterior horn of RT lateral ventricle suggestive of bleed . Optic Fundi showspaucity of blood vessels left more than rt ,left possible cherry red spot. Antivenom initial 10 vials,total 10 to 30 vials, treatment as per protocol. Check for coagulation parameters,monitor renal function
Snake bite if we can have perfect access for any disease today in allopathy, then we should opt for the same. i think, we should always treat snake bite with the help of allopathy. it is very rare to treat it with pure Ayurveda.
Hematological presentation of snake bite. Anti snake venom is first treatment.. symptomatic management and FFP or platelets are given or cryoprecipitate for hemostasis.
Coagulation profile, blood transfusion if law hematocrit,