title: Challenges of managing snakebite envenomation in a deployed setting.
abstract: Snake bite envenomation causes a significant health burden globally, especially in austere or resource poor settings. This case series describes envenomation in two adults and two children presenting to the Role 3 Medical Treatment Facility in Camp Bastion, Afghanistan. Each case has similarities with respect to the coagulopathy of envenomation but differs in terms of time delay to presentation and response to treatment, including reactions to antivenom. We discuss the challenges and ethical dilemmas in delayed-presentation snakebite, the diagnosis and treatment of coagulopathy and the role of antivenom and surgical debridement.
authors.affiliation: School of Anaesthetics and Intensive Care Medicine, Northern Deanery, Newcastle upon Tyne, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Johnson
authors.forename: J
authors.initials: J
authors.lastname: Rimmer
authors.forename: G
authors.initials: G
authors.lastname: Mount
authors.forename: I
authors.initials: I
authors.lastname: Gurney
authors.forename: E D
authors.initials: ED
authors.lastname: Nicol
mesh_terms: D000346:Afghanistan; D000997:Antivenins; D001778:Blood Coagulation Disorders; D006801:Humans; D012909:Snake Bites / Q000628:therapy
chemical_list: D000997:Antivenins
keywords: CHEMICAL PATHOLOGY; INTENSIVE & CRITICAL CARE; TOXICOLOGY