Acidentes ofídicos na população pediátrica em um hospital universitário no norte do Brasil: uma proposta de ensino em saúde

Abstract

Snake bites represent an important public health problem in Brazil (when it occur in children complications are more serious) research on the subject involving the pediatric population is still scarce in the literature. The understanding of regional epidemiology favors the installation of public policies, both preventive and assistance. We aimed to propose health teaching strategies for the lay population in the face of snakebites in the pediatric population treated at a university hospital in northern Brazil. This is a descriptive, epidemiological retrospective study with a quantitative approach. Data collection was carried out through the analysis of notification forms and medical records attended from January 2015 to December 2019. Medical records and notification forms from the National Notification System (SINAN) of 107 patients who attended in the period were analyzed. The epidemiological dynamics revealed that 58.9% (n=63) of the male gender, the age group between 5 and 10 years old in 58.9% (n=63), with a higher prevalence of care in the months of December, January, March and May. Faced with social dynamics, most were from rural areas (61.7%), residents of the municipality of Araguaína (30.8%), being taken to hospital between 1 and 3 am after the accident (29%). The type of accident was mostly bothropic (63.6%) and the affected anatomical region was the foot (63.5%). 48.6% (n=52) of the visits were considered mild accidents, moderate in 37.4% (n=40) and severe in 13.8% (n=15) of cases. Antivenom serum was used in 72.8% of patients (n=72), with antibothropic serum being the most used (57%). Of the number who used antivenom, 91% had no adverse reaction. When present, anaphylaxis was the most evident reaction to serum (6.4%). Antibiotic therapy was used in 43% (n=46) of the cases, with ceftriaxone being the most used in 30.4% (n=14), followed by the association of ceftriaxone and clindamycin in 23.9% (n=11) of the cases. The average time of antibiotic use was between 2 and 7 days in 73.9% (n=35). Clinical complications were observed in 29.9% (n=32) of the patients, with abscesses being the most prevalent a 43.8% (n=14), with a hospital stay between 2 and 7 days in 46.7% (n=50) of the times. In view of the epidemiological profile observed, it can be considered that children are a vulnerable population to snakebite in the north of Tocantins, and there should be a public health policy aimed at the pediatric population that involves parents, teachers and other caregivers. This objective study describes a rate of care/hospitalization due to care accidents/hospitalization due to medical care accidents in pediatrics and to propose educational material on pre-hospital care, aimed at the lay population that normally provides first aid, and the material was distributed to the Municipal Health Departments in the region of Araguaína. Thuis, it is believed that health education in the correct management of the first care can influence for a better prognosis of children victims of snakebites in the north of Tocantins. Other projects are needed in the sense of following up this pediatric group, through lectures strengthening the correct pre-hospital care for snakebite victims.