Đặc điểm dịch tễ học, lâm sàng, thực trạng sơ cứu và xử trí ban đầu bệnh nhân rắn độc cắn tại Bệnh viện Hữu nghị Đa khoa Nghệ An

Venomous snake bite is a critical public health concern globally and particularly in Vietnam, leading to significant morbidity and mortality with severe long-term sequelae. Annually, millions worldwide suffer from snakebites, a substantial proportion resulting in death or permanent disability, especially in Asia and Africa. The diverse nature of snake venom necessitates accurate diagnosis and appropriate initial management. However, widespread misconceptions and incorrect first aid practices often exacerbate patient outcomes, potentially causing irreversible damage or even death. This study aims to provide crucial insights into the epidemiological and clinical characteristics of venomous snake bite patients, while also evaluating the current status of first aid and initial treatment strategies at Nghe An General Friendship Hospital, contributing to improved patient care and public health interventions.

Medical professionals, emergency physicians, public health practitioners, researchers in tropical medicine, and healthcare policymakers.

This descriptive cross-sectional study investigated the epidemiological and clinical features, alongside the first aid and initial treatment practices, among 117 patients admitted for venomous snake bite at Nghe An General Friendship Hospital between November 2022 and August 2023. Epidemiological findings revealed a male predominance (61.5%), with farmers (37.6%) and self-employed individuals (17.9%) being most affected. Bites predominantly occurred in rural (45.3%) and mountainous (41.9%) areas, frequently at work (45.3%) or at home (33.3%). The most common snake families were Cobra (65%, including 41% cobras) and Vipers (31.6%), with Kraits and corporate snakes accounting for 9.4%. Bites were frequently on hands/fingers (50.4%) and feet/toes (42.7%), with 71.8% of patients hospitalized within six hours. Clinically, cobra bites typically presented with severe pain (96.9%), swelling (93.8%), and necrosis (63%), while viper bites caused swelling (91.8%), pain (86.5%), and bleeding (35%). Krait and corporate snake bites were characterized by drooping eyelids and dysphagia (54.5%). The study highlighted a concerning low rate of correct first aid (wound washing 28.2%, immobilization 12.8%) and a high prevalence of improper methods, such as tourniquets (71.7%), leaf poultices (45.3%), and incision/bleeding (30.7%). While 61.5% of patients received initial treatment at frontline facilities, wound cleaning (48.6%) and tetanus serum (34.7%) were common, 20.8% received no treatment. These results underscore that venomous snake bite continues to pose a significant health challenge, particularly for agricultural and self-employed populations. The prevalence of inappropriate first aid techniques emphasizes the urgent need for enhanced public education and training for both the general public and healthcare providers to improve early management and prevent severe complications.