Application of Sonographic Assessments of the Rate of Proximal Progression to Monitor <i>Protobothrops mucrosquamatus</i> Bite-Related Local Envenomation: A Prospective Observational Study

Abstract

Patients bitten by Protobothrops mucrosquamatus typically experience significant pain, substantial swelling, and potentially blister formation. The appropriate dosage and efficacy of FHAV for alleviating local tissue injury remain uncertain. Between 2017 and 2022, 29 snakebite patients were identified as being bitten by P. mucrosquamatus. These patients underwent point-of-care ultrasound (POCUS) assessments at hourly intervals to measure the extent of edema and evaluate the rate of proximal progression (RPP, cm/hour). Based on Blaylock’s classification, seven patients (24%) were classified as Group I (minimal), while 22 (76%) were classified as Group II (mild to severe). In comparison to Group I patients, Group II patients received more FHAV (median of 9.5 vials vs. two vials, p-value p-value p-value P. mucrosquamatus, the deceleration of RPP may serve as an objective parameter to help clinicians decide whether to withhold FHAV administration.

Keywords

• <i>Protobothrops mucrosquamatus</i>
• rate of proximal progression
• freeze-dried hemorrhagic antivenom
• point-of-care ultrasound
• snakebite