Snake bite envenomation: experience at King Abdulaziz Medical City, Riyadh

We surveyed the records of 21 of the 28 snakebite victims seen at King Fahad National Guard Hospital in Riyadh over the 20-year period 1986-2005. The most common symptoms were local pain and swelling and the most common signs oedema and tenderness. Neurotoxicity was not noted in any case. Coagulopathy was recorded for 14/21 patients [66.7%] and 5/19 [26.4%] had leukocytosis. All patients were given tetanus toxoid [100%] and 20 [95.2%] received antivenom. Blood products were administered in 2 cases and prophylactic antibiotics in 10 [47.6%]. No allergic reaction to antivenom was reported

Whole blood/packed blood cell ordering practices in a University Hospital: a call for better blood utilization

An analysis of the pattern of blood usage in the King Khalid University Hospital [a 660 bed referral hospital], Riyadh, indicated a high ratio of crossmatched to transfused [C/T ratio] blood units. This raises concern about ineffective use of blood. Cumulative figures for the years 1987 to 1989 were analysed for various hospital divisions. The C/T ratio approached unity in the renal dialysis unit, medicine and in paediatrics, i.e. non-surgical use of blood transfusion. The highest C/T ratios were in the departments of obstetrics/gynaecology and surgery, due to a formal 'ordering policy for crossmatching of 2 units of blood for a wide range of surgical procedures where blood is seldom transfused. These operations include cholecystectomy, thyroidectomy, transurethral resection of the prostate, vagotomy, mastectomy, Caesarean section, hysterectomy, and myomectomy. In addition, ordering of whole blood instead of packed red blood cell [PRBC] occasionally created chronic shortages of platelet concentration, cryoprecipitate, and FFP that was aggravated by the expansion of the oncology unit. A policy of 'group and screen' and routine packed RBC transfusion are gradually being introduced to replace crossmatching in those surgical procedures with very high C/T ratios. When the system is fully operational, it will be helpful in reducing the disadvantages of the current unnecessary crossmatching such as [i] ineffective use of personnel time; [ii] wastage of reagents; [iii] high rate of outdating of blood units; and [iv] shortages of blood bank components