個人簡歷 

Education/Training:

• 2015-2022: Ph.D. in National Taiwan University, College of Medicine, Graduate Institute of Toxicology, Taiwan
• 1999-2008: M.D. in National Defense Medical Center, School of Medicine, Taiwan

Professional and Research Experience:

• 2006 – 2008: Military Doctor / Lieutenant
• 2008 – 2012: Resident in Emergency Department, Tri-Service General Hospital
• 2013 – Present: Attending Physician

Awards and Honors:

• (None)

Selected Publications:

1. Sun I, Lee ST, Chen YG, Mao YC, Chen FC, Chen YH, Tsai SH, Ho CH. Thromboembolic events following a pit viper bite from Protobothrops mucrosquamatus (Taiwan Habu): A report of two cases. Toxicon. 2024 Feb 1;238:107572. doi: 10.1016/j.toxicon.2023.107572. Epub 2023 Dec 23. PMID: 38145881.
2. Chen FC, Ismail AK, Mao YC, Hsu CH, Chiang LC, Shih CC, Tzeng YS, Lin CS, Liu SH, Ho CH. Application of Sonographic Assessments of the Rate of Proximal Progression to Monitor Protobothrops mucrosquamatus Bite-Related Local Envenomation: A Prospective Observational Study. Trop Med Infect Dis. 2023 Apr 24;8(5):246. doi: 10.3390/tropicalmed8050246. PMID: 37235294. Free PMC article.
3. Ho CH, Chiang LC, Mao YC, Lan KC, Tsai SH, Shih YJ, Tzeng YS, Lin CS, Lin WL, Fang WH, Chen KT, Lee CH, Chiang DM, Liu SH. Analysis of the Necrosis-Inducing Components of the Venom of Naja atra and Assessment of the Neutralization Ability of Freeze-Dried Antivenom. Toxins (Basel). 2021 Sep 2;13(9):619. doi: 10.3390/toxins13090619. PMID: 34564623. Free PMC article.
4. Ho CH, Ismail AK, Liu SH, Tzeng YS, Li LY, Pai FC, Hong CW, Mao YC, Chiang LC, Lin CS, Tsai SH. The role of a point-of-care ultrasound protocol in facilitating clinical decisions for snakebite envenomation in Taiwan: a pilot study. Clin Toxicol (Phila). 2021 Sep;59(9):794-800. doi: 10.1080/15563650.2021.1881535. Epub 2021 Feb 19. PMID: 33605805.

Abstract

Chinese Title:

台灣蛇傷臨床處置與超音波介入應用

English Title:

Clinical Management of Snakebites in Taiwan and Ultrasound Intervention Applications

Abstract 

The World Health Organization declared snakebite injury a neglected tropical disease in 2017. Taiwan's case fatality rate for snakebite envenomation (SBE) is lower than that of high-incidence countries, thanks to superior antivenom quality, easily accessible medical resources, and clear clinical strategies. Snake bites have strong regional characteristics and can lead to various complications. Thus, it's crucial for clinicians to understand the specific epidemiological and bite characteristics of snake bites in their areas. We developed a management strategy for snakebite patients called "S.N.A.K.E.": (1) Species identification (2) Notification (3) Antivenom administration (4) Keeping the patient under observation (5) Evaluation of surgical risk factors. Clinicians identify snake species through visual cues or the snake's body. When visual information is limited, details about the bite incident and SBE-related symptoms can help identify the species. Some hospitals use immunoassays for identification, and artificial intelligence could become a crucial tool for this purpose. A pretreatment discussion between clinicians and patient about potential clinical outcomes can foster trust and reduce anxiety. The appropriate antivenom is then selected, and the patient's response is monitored, focusing on issues such as venom-induced consumption coagulopathy (VICC), respiratory failure, and local tissue damage. Finally, surgical risk factors for debridement are assessed. In Taiwan, common venomous snakes include Protobothrops mucrosquamatus, Trimeresurus stejnegeri, Naja atra, and Bungarus multicinctus. The antivenom types are freeze-dried hemorrhagic antivenom (FHAV) for P. mucrosquamatus and T. stejnegeri, and freeze-dried neurologic antivenom (FNAV) for N. atra and B. multicinctus. While immediate anaphylactic reactions to antivenom are rare, delayed reactions can occur. Local injuries require significant attention, with point-of-care ultrasound (POCUS) used to monitor injuries and guide antivenom volume. Infection and necrosis are concerns, particularly with N. atra bites, which may require antibiotics and sometimes debridement or amputation if risk factors such as finger bites, blisters, or fever are present. In summary, while treatments vary by snake species and region, the "S.N.A.K.E." strategy can be universally applied to snakebite patients.