| dc.description.abstract | Abstract:-A mix method study was conducted
at the Teaching hospital, Anuradhapura (THA)
to describe the demographic characteristics of
snake bites, determine the median time gap of
administering anti-venom, identify reasons
for delaying administration of anti-venom
serum and propose measures to be adopted in
order to shorten the door to needle time gap.
Ethical approval was obtained by ethical
committee, Faculty of Medicine, KDU. The
descriptive cross-sectional part was based on
snake bite victims elder than 16 years(n=50)
who were admitted to the THA and received
AVS (Anti-venom serum) therapy over a 3 ½
months period from 15th July 2019 and 50
victims were sample size for quantitative
study. The data was collected through an
interviewer administrated questionnaire
.Participants were purposively recruited for
the qualitative study and in-depth interviews
were conducted with health care
professionals in THA and peripheral hospitals.
Qualitative data analyzed by thematic analysis
with four themes including limited physical
and human resources, issues in the diagnosis
of envenoming, delays in preparation of AVS,
reasons and delays in transferring patients
from the local hospital to THA. Data were
analyzed by using SPSS 23 with Mann-
Whitney U test.
There were 88% (44) male and 12% (8)
female victims. The most bites were not
identified (50%) and most of the common bite
were Russell's viper (46%).Below the ankle
82% and between 6 a.m. to 6 p.m. was the
commonest bite site and time. There were 40
(80%) indirect admissions and 10 (20%)
direct admissions. Door to needle median gap
of all direct and indirect admission was 125
(IQR= 65-158) minutes. Door to needle
median gap in indirect admissions was 178
(IQR=90-210) minutes and direct admissions
median gap was 72 (IQR=30-104) minutes.
There was a significant difference between the
median time gap of indirect and direct
admissions. Poor rural hospital facilities,
overcrowding, inadequate staffing and the
unavailability of quality tubes for whole blood
clotting time are the main factors contributing
to the time gap. Final suggestions are
increasing bed capacity and implementation
of a triage system in the ETU. | en_US |
