ISSN: 2474-3674 Luo et al. Int J Crit Care Emerg Med 2020, 6:099 DOI: 10.23937/2474-3674/1510099 Volume 6 | Issue 1 International Journal of Open Access Critical Care and Emergency Medicine RESEARCH ARTICLE Preliminary Discussion of the Distribution Characteristics of Ven- omous Snake Species in One City and Four Counties in Guangxi and the Diagnosis and Treatment Strategies of Snakebite based on the Classified Evidence Method Yi Luo1, Zhengzhao li2, Jianfeng Zhang2*, Qibin Li3, Chongyu Zhai4, Peinan Yu5 and Peng Guo6 1Liuzhou People's Hospital, Liuzhou Hospital of Traditional Chinese Medicine, Snakebite Treatment Base in North and Central Guangxi, China 2The Second Affiliated Hospital, Guangxi Medical University, China Check for 4The First Affiliated Hospital, Guangxi Medical University, China updates 5Liuzhou Hospital of Traditional Chinese Medicine, Snakebite Treatment Base in North and Central Guangxi, China 6Wuzhou Hospital of Traditional Chinese Medicine, China 7School of Life Sciences and Food Engineering, Yibin College, China *Corresponding author: Jianfeng Zhang, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China Abstract clinical picture evidences had been collected by the snake- bite treatment base in north and central of Guangxi, by whi- Objective: From the perspective of clinical diagnosis and ch 11 species of venomous snake were confirmed. Finally, treatment of snakebite and combined with existing zoologi- confirming the distribution of venomous snake species in cal data, we aimed to characterize the distribution of snake one city and four counties in Guangxi by Integrating level I, species in one city and four counties in Guangxi and make II and III evidence. regional snakebite diagnostic charts. Conclusion This study indicated that the distribution cha- Methods: Geolocation data of the research region and sna- racteristics of venomous snake species according to the ke distribution were collected from the municipal and county counties and cities provided strategies for snakebite dia- governments and referring to authoritative zoological mo- gnosis and treatment. nographs, respectively. We characterized the distribution of venomous snake species using hierarchical evidence Keywords method. Distribution of venomous snake, A book of regional diagno- Results: 92 species of snake (25 poisonous and 67 sis of snakebite, Diagnosing of snakebite quickly and ac- non-poisonous snakes) were identified according to zoolo- curately gical monographs, which belong to 40 genera, 4 subfami- lies and 6 families. There were 15 clinical specimen eviden- Introduction ces of grade Ia venomous snakes, which were divided into 3 families, 3 subfamilies, 8 genera and 9 species of snake, Toxicological mechanisms of venomous snake zoolo- and there were 35 research specimen evidences of grade gy vary largely. Obvious differences existed in the clini- I venomous snakes, which were divided into 3 families, 3 b cal manifestations of snakebite and targeted treatment subfamilies, 10 genera and 11 species. The survey cove- red one city, four counties, 31 towns, 13 townships and 207 methods. There are a total of 240 species of snake in villages. 1,001 pieces of grade II evidence were collected, China, including 69 species of venomous snake and 171 and 20 species of distributed snake were confirmed to be species of non-venomous snake [1]. Due to the diffe- venomous. In the long-term clinical practice, 233 class III rent climatic conditions and geographical features of Citation: Luo Y, li Z, Zhang J, Li Q, Zhai C, et al. (2020) Preliminary Discussion of the Distribution Char- acteristics of Venomous Snake Species in One City and Four Counties in Guangxi and the Diagnosis and Treatment Strategies of Snakebite based on the Classified Evidence Method. Int J Crit Care Emerg Med 6:099. doi.org/10.23937/2474-3674/1510099 Accepted: March 09, 2020: Published: March 11, 2020 Copyright: © 2020 Luo Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Luo et al. Int J Crit Care Emerg Med 2020, 6:099 • Page 1 of 9 • DOI: 10.23937/2474-3674/1510099 ISSN: 2474-3674 different regions in China, there are significant differen- longitude and average altitude of the research region, ces in the distribution of snake species, which determi- we framed the zoological distribution of snake species nes regional characteristic of the treatment of snake- in this area. In this study, sea snakes were excluded bite. Snakebite most commonly occurs in counties and owing to the absent information of the geographical fe- prefecture-level cities, and the patients generally seek atures of the sea region. medical treatment in county and municipal hospitals. However, the materials of snake zoology distribution in Survey map and questionnaire of snake species these regions are lacking, so the cure rate of snakebite distribution is low. Consequently, it is of significant importance to We obtained the appearance and morphology infor- diagnose accurately and treat directly of snakebite on mation of each snake and then accomplished a survey the basis of snake zoology classification. map of snake species in the research region by referring At present, zoology literature related to snake in to the monograph of Chinese Snakes and searched pi- China is snake distribution materials in each province. ctures of snake species on the Internet. However, relatively little is known about the snake zoo- The questionnaire was designed according to the logy distribution in each city and county [2]. The distri- name of the snake species. The questionnaire included bution of snake species varies greatly in different area the information of the interviewees and the snake spe- of the same province. Medical staffs in prefectural and cies in the corresponding research area. county-level hospitals have no authoritative material We applied and obtained the snake catching licen- of the distribution of local snake species and have little se from Liuzhou forestry administration department for knowledge of snakes, which leads to the lack of perti- the reason of clinical scientific research of snakebite. nence and poor curative effect in the diagnosis and tre- Live snake specimens were collected and identified in atment of snakebite. There is no objective theoretical Liuzhou city and counties and one snake of each species basis for constructing a regional snakebite treatment was preserved as the evidence material. network centered on prefecture-level hospitals. There- Collection of Grade I evidence: In the clinical practi- fore, we aim to characterize the distribution of snakes in ce of the snakebite treatment base in north and central counties and cities from the perspective of clinical dia- of Guangxi, we collected those snake specimens which gnosis of snakebite. were killed and brought to the hospital by snakebite pa- Materials and Methods tients as clinical specimen evidence aI . The clinical infor- mation included snake name, patient name, bite time, Research region bite site, bite address, bite reason and telephone. The research region covered Liuzhou City and four After consulting local professional and semi-profes- surrounding counties of Guangxi Province (Liujiang sional snake catchers in the process of carrying out que- County (district), Luzhai County, Liucheng County and stionnaire survey in districts, towns and townships un- Xiangzhou County), which are located in the central der the jurisdiction of cities and counties, we collected and northern part of Guangxi Zhuang Autonomous Re- contact information of the snake catchers to build sna- gion, between latitude 23°54 '~ 24°26' and longitude ke catching relationship network through We Chat pla- 108°54'~110°12', with an area of 10,624 square kilo- tform. The snake catchers were requested to collect one meters and a population of 2,942,700 (data of statistics wild snake from each species in research area where he bureau in 2018). The region has a subtropical monsoon or she lived. Live snakes we collected saved as scien- climate, with an annual average temperature of 20.5 °C, tific research specimens of evidenceb I . Relative infor- with a sufficient sunlight with an annual average sunshi- mation were recorded including specimen collection ne of 1634.9 hours and abundant rainfall with an annual address, altitude, longitude and latitude, and specimen average rainfall of 1450 mm. The landform of the region collection time. is characterized with typical karst landform features Collection of Grade II evidence: A questionnaire of many gentle hills, platforms and small plains, with a relative low altitude (85 and 105 meters) [3]. The eco- survey was conducted in the research region to col- logical environment of the research region is excellent, lect the information of the snake species that they with four season’s evergreen and vigorous vegetation. had seen. The interviewees were mainly local far- Such natural conditions are suitable for the growth and mers, professional snake catchers and semi-profes- reproduction of snakes. sional snake catchers. Snake pictures for the referen- ce snake species were provided as visual aids. The in- Distribution of snakes formation of collected questionnaires were summari- We obtained the geographic information, including zed as grade II evidence of snake species distribution. longitude and latitude, vertical