CCTC SNAKEBITE CLINIC
Our Snakebite Clinic in the Emergency Department at the Port Moresby General Hospital is the only facility of its kind in Papua New Guinea, and provides 24 hour-a-day access to specialist treatment of bites and stings by a wide range of venomous animals.
We treat 325-400 snakebite victims each year, including 50-60 critically ill rural patients whose lives are saved by the medical teams we deploy to retrieve them in our Mobile Intensive Care Ambulance. Without this life-saving service many of these patients would die before ever arriving at hospital. Our medical staff provides expert advice by telephone to remote health centre staff managing snakebite cases in other areas of PNG, and our snakebite treatment protocols are in use throughout PNG. In Port Moresby, the introduction of our protocols for the treatment of snakebite during 2006-2008 resulted in case fatality rates of 14.9% dropping to just 2.2%. The rate is still reducing and was 1.5% in 2015.
We see between 11 and 43 patients each month, but on some occasions we care for as many as 6-8 envenomed snakebite patients at one time. Men and boys make up 61% of the cases we treat, with a median age of 23±1.3 years, compared to the median age of 25±1.6 years for women and girls. Boys less than 16 years of age make up 29.7% of cases, while 25.2% of female patients are girls less than 16 years old.
Our focus is upon ensuring that all patients are managed according to a standardized protocol which ensures that as soon as a diagnosis of snakebite envenoming is confirmed, antivenom is administered without delay, and airway and breathing problems are expertly and promptly treated to reduce morbidity and increase patient safety.
The Snakebite Clinic operates within the Emergency Department with a high degree of autonomy, with dedicated full-time staff, and a range of equipment that enables us to manage up to two ventilated patients at a time to Intensive Care standards. We have full patient monitoring and advanced resuscitation facilities, and use Dräger Oxylog 3000+ ventilators to support patients with airway obstruction or respiratory compromise due to the effects of envenoming.
Our diagnostic capacities include bedside point-of-care (POC) blood chemistry and blood gas analysis, venom-detection immunoassays, electrocardiography and our laboratory-based haemostasis and haematology services. Within the hospital we have access to radiology, computerized axial tomography (CT), microbiology and additional pathology services, and in-patient care in both high dependency (HDU) and intensive care units (ICU).
As well as serving the Port Moresby community and an extensive rural catchment that ranges as far west as Kerema (capital of Gulf Province) and to the communities of the Abau District in the far east of Central Province, our services are also provided to the expatriate community and to the business, forestry, agriculture, oil and gas sectors.