Acute poisoning with various substance is common everywhere. The earlier the initial resuscitations, gastric decontamination and use of specific antidotes, the better the outcome. The aim of this study was to characterize the poisoning cases admitted to the tertiary care hospital, Warangal district, Andhra Pradesh, Southern India. All cases admitted to the emergency department of the hospital between the months of January and December, 2007, were evaluated retrospectively. We reviewed data obtained from the hospital medical records and included the following factors: socio-demographic characteristics, agents and route of intake and time of admission of the poisoned patients. During the outbreak in 2007, 2,226 patients were admitted to the hospital with different poisonings; the overall case fatality rate was 8.3% (n = 186). More detailed data from 2007 reveals that two-third of the patients were 21–30 years old, 5.12% (n = 114) were male and 3.23% (n = 72) were female, who had intentionally poisoned themselves. In summary, the tertiary care hospitals of the Telangana region, Warangal, indicate that significant opportunities for reducing mortality are achieved by better medical management and further sales restrictions on the most toxic pesticides. This study highlighted the lacunae in the services of tertiary care hospitals and the need to establish a poison information center for the better management and prevention of poisoning cases.
Background: Neuro-paralysis leading to type II respiratory failure is the most important cause of morbidity and mortality in victims bitten by venomous snakes of Elapidae family. In-hospital cardiac arrests are secondary to presumed acute respiratory compromise and an excellent outcome can occur after well-choreographed, high quality cardio-pulmonary resuscitation. Compartment syndrome is characterized by an increase in intra-compartmental pressure with subsequent neurovascular compromise and tissue necrosis. Hence early necrectomy and debridement are indicated in such instances. Case Report: We herewith report a case of snake bite with cardiac arrest following severe neurotoxic envenomation, was managed successfully in our critical care. In our case, the presentation was late, resulting in a substantial delay in anti-venom therapy. The resultant delay contributed to a significant morbidity and prolonged hospital admission. Conclusion: The case report illustrates some practical difficulties faced by clinicians pertaining to complications. Institution of appropriate therapy without delay results in better outcome, including in a rural critical care setting.
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