Prehospital Practices and Clinical Profile of the Patients with Snake Envenomation Admitted in a Tertiary Care Hospital: A Case Series.

Introduction: Snake envenomation is a common life-threatening medical emergency, especially in rural areas where limited access to healthcare and a lack of awareness about proper first-aid procedures often lead victims to rely on traditional healers before seeking modern treatment. These practices, such as the use of tourniquets, pressure immobilization, and native concoctions, might result in adverse outcomes and cause delays in seeking medical assistance. Methodology: This Case series design was conducted to identify the prehospital practices among patients with snake envenomation who presented to the emergency department of a tertiary care hospital. The study included 100 adult participants with definite characteristics of snake envenomation. Consecutive sampling was used to select participants, and data collection focused on clinico-epidemiological profiles and prehospital practices, including traditional remedies and first aid measures. Continuous variables were presented as mean ± standard deviation or median, and associations were assessed using Chi-square or Fisher's exact test. Results: Participants had a mean age of 45.5 ± 15.6 years, with male predominance (71%) and the highest incidence in the 31-45 age group (33%). Most were from rural areas (94%). The median time from the bite to hospital admission was 90 minutes (IQR 4-180 minutes). 56% of participants used various methods before reaching the hospital. Washing the bite site with water and soap was the most common (19%), followed by topical native concoctions (17%) and pressure immobilization (17%). Conclusion: The study showed that various prehospital practices among patients were associated with threefold higher odds of delay in arriving at the hospital. The public should be educated to prevent unnecessary delays in transporting patients to the hospital because of these practices.