Professional Documents
Culture Documents
Dr.Pratheeba Durairaj,
M.D.,D.A,
● Farmers (rice)
● Plantation workers (rubber, coffee)
● Herdsmen
● Hunters
● Snake handlers (snake charmers and in snake
restaurants and traditional Chinese pharmacies)
● Fishermen and fish farmers
● Sea snake catchers (for sea snake skins,
leather)
Pit vipers
calloselasma rhodostoma malayan pit viper
Hypnale hypnale hump-nosed viper
Green pit vipers or bamboo vipers (genus trimeresurus)
T albolabris white-lipped green pit viper
T gramineus indian bamboo viper
T mucrosquamatus chinese habu
T purpureomaculatus mangrove pit viper
T stejnegeri chinese bamboo viper
● The nostril pits respond to the heat emission of the prey, which
may enable the snake to vary the amount of venom delivered.
• Fang marks
• Local pain
• Local bleeding
• Bruising
• Lymphangitis
• Lymph node enlargement
• Inflammation (swelling, redness, heat)
• Blistering
• Local infection, abscess formation
• Necrosis
● General
● Nausea, vomiting, malaise, abdominal pain,
weakness, drowsiness, prostration
● Cardiovascular (Viperidae)
● Visual disturbances, dizziness, faintness, collapse,
shock, hypotension, cardiac arrhythmias,
● pulmonary oedema, conjunctiva oedema
● SYNDROME 2
● Local envenoming (swelling etc) with bleeding/clotting disturbances,
● shock or renal failure
= Russell’s viper and possibly saw-scaled viper - Echis species - in
some areas)
● with conjunctival oedema (chemosis) and acute pituitary
insufficiency =
● Russell’s viper, Burma
with ptosis, external ophthalmoplegia, facial paralysis etc and dark &
brown urine
= Russell’s viper, Sri Lanka and South India
● SYNDROME 3
● Local envenoming (swelling etc) with paralysis
= cobra or king cobra
● SYNDROME 5
● Paralysis with dark brown urine and renal failure
● Bite on land (with bleeding/clotting disturbance) =
Russell’s viper, SriLanka/South India
● Bite in the sea (no bleeding/clotting disturbances) = sea
snake
● Chronic renal failure occurs after bilateral cortical necrosis
(Russell’s viper bites) and chronic panhypopituitarism or
diabetes insipidus after Russell’s viper bites in Myanmar
and South India
• Rapid early extension of local swelling from the site of the bite
• Tender enlargement of local lymph nodes, indicating spread of
venom in the lymphatic system
• Systemic symptoms: collapse (hypotension, shock)
nausea, vomiting,diarrhoea
severe headache
“heaviness” of the eyelids
inappropriate drowsiness
early
ptosis/ophthalmoplegia
• Early spontaneous systemic bleeding
• Passage of dark brown urine
● Imaging Studies:
● Baseline chest radiograph in patients with pulmonary
edema
● Plain radiograph to rule out retained fang
●
Other Tests: Compartmental pressures may need to
be measured.
●
Measurement of compartmental pressures is
indicated when significant swelling is present, pain is
out of proportion to exam, and if paresthesias are
present in the affected limb.