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How to manage a snake bite

Morphological identification key (general)
Morphological identification key (regional)
Distribution tables
Biological tables

 

In some cases of systemic envenoming it is necessary to more closely identify the snake that caused the bite for the purpose of specific treatment with antivenom. Fundamentally there are two possible scenarios:

 

  1. The snake that caused the bite was brought in by the patient and is available for morphological identification. In this case proceed to the morphological identification key. If by this means the snake can be identified at the genus level, the relevant Biomedical database entries can be consulted. These list all the antivenoms for which there is information regarding efficacy. In any case the WHO Antivenom list provides a guide to the available antivenoms. If it is necessary to identify the snake at the species level in order to choose the correct antivenom, the biological descriptions in the Biomedical database entries can be used as an aid. 
  2. The snake is not available for morphological identification. In this situation, it is firstly necessary to identify which snake species are found in the country in question by means of the relevant Distribution table. In this way, the number of eligible species is dramatically reduced. The next step is to further narrow down the possibilities with the aid of the Biological tables, by means of various criteria. At this stage there should only be a few genera that could possibly have caused the bite. Additional information regarding these genera can be found and compared in the corresponding Biomedical database entries. 

 

  • In the Morphological identification key, the region "Australia and the Pacific Islands" has not been included, as morphological identification is difficult in this region. Moreover, an ELISA test kit and a polyvalent antivenom are available that cover the whole of Australia. Both are manufactured and distributed by the company CSL (see WHO Antivenom list).

 

  • In the Biological tables, both the regions "Australia and the Pacific Islands" and "Europe" have been omitted. With regard to the former, this is because of the reasons mentioned above. For Europe, closer identification of the snake that caused the bite is not necessary, as it is practically only the genus Vipera that regularly causes envenoming.

 

 

Did the accident occur in Australia, New Guinea or the Pacific Islands? yes   Use the commercially available ELISA test kits for Australia.

If not available or if the accident occurred outside Australia?
no     yes
         
   

Where did the accident take place?:

Identify the relevant region (see map below).

 

Proceed to the Distribution tables. Identify those snakes that could possibly have caused the bite and that are found in the relevant region and compare them by means of the Biological tables.

1a North America

1b Mexico and Central America

1c South America and the West Indies

2 Europe

3 North Africa, Near and Middle East

4 Central and Southern Africa

5a The Far East


5b Indian Subcontinent and Southeast Asia

6 Australia and the Pacific Islands

 
   

 

Is the snake available for inspection?

 

no  
yes      
       

 

» proceed to morphological identification

 

     

 

  Map of the world regions