title: Snake bites in north east Sri Lanka.
abstract: BACKGROUND
  Snake bite is a major problem in Sri Lanka where recent decades of warfare and economic sanctions have complicated its management.
  
  
  RESULTS
  A retrospective review of snake bites in north-east Sri Lanka was undertaken in 2005 to review management. Of 303 victims, 145 revealed a local response, 134 a prolonged clotting time, 46 ptosis and five respiratory failure. One died. Of 97 snakes identified: 42 were saw-scaled vipers, 14 Russell's vipers, 6 cobras and 6 kraits. Most bites occurred at the harvest and the median age of victims was 32 years. There was no difference in morbidity or mortality at any age. In total, 262 snake bite cases were treated within 3 hours of the bite, and 183 were given antivenom. Seventy victims reacted adversely, of whom 61 received hydrocortisone, chlorpheniramine and subcutaneous adrenaline. No significant side effects were noted.
  
  
  CONCLUSIONS
  North-east Sri Lanka has endured two decades of civil disruption but public knowledge and an established protocol for management, including adrenaline, has compensated for shortages in medical staff and infrastructure. The resumption of economic sanctions in 2007 is likely to counter that success.
authors: The Townsville Hospital, Queensland Health, Townsville, Queensland, Australia. john_whitehall@health.qld.gov.au
authors: J S
authors: JS
authors: Whitehall
authors: Yarlini
authors: Arunthathy
authors: Varan
authors: Kaanthan
authors: Isaivanan
authors: Vanprasath
mesh_terms: D000293:Adolescent; D000328:Adult; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000997:Antivenins / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D004837:Epinephrine / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011398:Promethazine / Q000627:therapeutic use; D012189:Retrospective Studies; D019035:Rural Health Services / Q000191:economics / Q000600:supply & distribution*; D012909:Snake Bites / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D012910:Snake Venoms / Q000506:poisoning*; D013188:Sri Lanka / Q000453:epidemiology; D013997:Time Factors; D014857:Warfare; D000078329:Workforce
chemical_list: D018926:Anti-Allergic Agents; D000893:Anti-Inflammatory Agents; D000997:Antivenins; D012910:Snake Venoms; D011398:Promethazine; D006854:Hydrocortisone; D004837:Epinephrine