Simpson Ian D
Pakistan Medical Research Council, Islamabad, Pakistan.
Trans R Soc Trop Med Hyg. 2008 Nov;102(11):1108-14. doi: 10.1016/j.trstmh.2008.04.013. Epub 2008 May 27.
The call for greater production of better quality anti-snake venom (ASV) is a major thrust in the effort to reduce snake bite mortality. However, snake bite mortality has many causes and these should also be addressed. A key feature of efficient ASV usage is ensuring that doctors are trained to administer ASV only when it is required and in amounts that are necessary to neutralize venom. The need for better snake bite management training has been referred to, but little attention has been paid to how effectively medical education actually prepares doctors to treat snake bite. The objective of this study is to evaluate the current level of knowledge amongst doctors in India and Pakistan, two countries with the highest snake bite mortality in absolute terms. Results show that the use of current textbooks and medical education do not adequately prepare doctors to treat snake bite, particularly in the areas of use of ASV, dealing with adverse reactions to ASV and specific measures to deal with neurotoxic bites. The central conclusion of the paper is that local protocols and training are required to adequately prepare doctors to improve treatment and reduce mortality.
呼吁生产更多质量更好的抗蛇毒血清(ASV)是降低蛇咬伤死亡率努力中的一项主要工作。然而,蛇咬伤死亡率有多种原因,这些原因也应得到解决。有效使用抗蛇毒血清的一个关键特征是确保医生接受培训,仅在需要时并以中和毒液所需的剂量来使用抗蛇毒血清。人们已经提到需要更好的蛇咬伤管理培训,但对于医学教育实际上如何有效地使医生做好治疗蛇咬伤的准备却很少关注。本研究的目的是评估印度和巴基斯坦这两个绝对蛇咬伤死亡率最高的国家医生的当前知识水平。结果表明,使用当前的教科书和医学教育并不能充分使医生做好治疗蛇咬伤的准备,特别是在抗蛇毒血清的使用、应对抗蛇毒血清的不良反应以及处理神经毒性咬伤的具体措施等方面。该论文的核心结论是,需要制定当地的方案和培训,以使医生充分做好准备,改善治疗并降低死亡率。