Clinical Flowchart
Autopharmacological effects
Not observed.
Local effects
“The bite is usually painless and may not be noticed by the wader or swimmer. Minimal or no local swelling.” (Warrell 2023).
Haematological effects
Not observed.
Neurological effects
|
Hydrophis stokesii (= Astrotia stokesii)
|
| Minutes to hours |
| Cranial nerve deficits (ptosis, ophthalmoplegia, dysphagia, dysarthria) |
| Paralysis of the skeletal musculature including the respiratory musculature |
| Respiratory failure |
Muscular effects
|
Hydrophis schistosus (= Euhydrina schistosa)
|
| Hours |
| Myalgia (at rest, with active/passive movement, upon pressure), dark urine, ECG changes (hyperkalaemia, hypercalcaemia) |
| Signs of paralysis |
| Skeletal muscle necrosis (rhabdomyolysis) |
| Respiratory failure (due to rhabdomyolysis) |
| Heart failure (due to hyperkalaemia, hypercalcaemia - rhabdomyolysis) |
| Acute renal failure (due to rhabdomyolysis) |
Cardiac effects
Secondary to rhabdomyolysis.
Renal effects
Secondary to rhabdomyolysis.