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Journal of Case Reports
Successful Management of Cardiac Arrest Following Cobra Bite: A Case Report from a Rural Critical Care Unit in India
Harish Handyal1, Gopi Kumar1, Ketty E. Arce2, Praveen Kumar Birru3 
Departments of 1Critical Care, 2Emergency Medicine, and 3Orthopedics; RDT hospital, Bathalapalli, Anantapur:515661, India.
Corresponding Author:
Dr. Harish Handyal
Email: drharry69@gmail.com
Received: 30-APR-2018 Accepted: 05-JUL-2018 Published Online: 15-JUL-2018
DOI: http://dx.doi.org/10.17659/01.2018.0046
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.
Keywords : Cardiac Arrest, Respiratory Paralysis, Compartment Syndrome, Snake-Bite Envenomation, Anti-Snake Venom (ASV).
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