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Early patient resuscitation is an important part of management, thus immediate transport to an emergency department is essential. This process may be facilitated by keeping the patient calm, 3,9 and immobilising the affected limb through splinting, to alleviate pain and reduce venom spread.
Me vs an eight-foot spitting cobra | The Spectator
Whenever possible the snake should be positively identified. Emergency room management. General measures include basic resuscitation as neurotoxic effects may cause respiratory compromise.
Although snake bites do not carry a high risk of tetanus exposure, patients should ideally receive toxoid prophylaxis. Specific treatment options include anti-venom 16 antisnakebite serum , analgesia and antimicrobials. The anti-venom should be crystal clear and without sediment before use. These are typically life-threatening, and should be managed accordingly. Adequate analgesia is essential during the acute management of the patient. Although morphine is a good emergency analgesic drug, it should be used with caution in the acute period after the bite, due to its respiratory depressant properties.
In general prophylactic antibiotics are not recommended for most snake bites, especially if good wound care is followed. Wound care and surgical intervention. Daily cleaning with soap and water, followed by sterile dressings is essential. Surgery may be indicated in the acute setting if compartment syndrome 23 is suspected.
Compartment syndrome can be confirmed using intracompartment pressure measurements, as described by Whiteside. Surgical exploration of the bite wound is not recommended.
A lion cub faces off against a spitting cobra
Therefore, early debridement has been discouraged by various authorities, and is typically advocated after day 6. Surgery in the first three days following the snake bite may be significantly complicated due to the underlying coagulopathy. This contributes to the current reasoning to delay early wound debridement. Orthopaedic surgeons are often consulted for management of limb injuries; therefore a thorough knowledge regarding management of cytotoxic snake bites should be a part of the general orthopaedic surgeon's training.
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Venomous animal injuries. Rosen's Emergency Medicine. Philedelphia: Mosby Elsevier; Mebs D. Venomous and poisonous animals. Stuttgart: Medpharm Scientific Publishers; Backshall S. Venomous animals of the world. Broadley D.
Fitzsimons' Snakes of Southern Africa. Johannesburg: Delta Books; Marais J. A complete guide to the snakes of Southern Africa. Stuart C, Stuart M.
Dangerous creatures of Africa. Cape Town: Struik Nature; The diagnosis and management of snakebite in dogs - a southern African perspective. S Afr Vet Ass. Tilbury C.
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Oberservations on the bite of the Mozambique spitting cobra Naja mossambica mossambica. Meier J, White J. Handbook of clinical toxicology of animal venoms and poisons. Blaylock R. Russel F.
Black-necked Spitting Cobra
Snake venom poisoning. New York: Scholium International; Wacklin H. Activation of the acidic isoform of phospholipase A2 from Naja mossambica mossambica venom by oleoyl imidazolide requires the cooperative action of two ionizing groups. Ackermann E, Taylor P. Nonidentity of the a-neurotoxin binding sites on the nicotinic acetylcholine receptor revealed by modification in a-neurotoxin and receptor structures. A snake in the clinical grass: late compartment syndrome in a child bitten by an adder. British Journal of Plastic surgery. It is also known to eat insects. It is active on overcast days, but more active at night, often ending up in houses where people are bitten while asleep.
This snake accounts for the majority of serious snakebite cases in Southern Africa but fatalities are rare. It also ejects it venom and does not always spread a hood when doing so. Its venom is potently cytotoxic causing pain, swelling, blisters and in many cases severe tissue damage. Antivenom is effective but needs to be administered sooner rather than later to prevent tissue damage. The rinkhals Hemachatus haemachatus is another elapid species, which, while not belonging to the cobra genus Naja , is closely related and spits venom as its primary defence.
From Wikipedia, the free encyclopedia. September Journal of Experimental Biology. Spitting behaviour and fang morphology of spitting cobras. Journal of Zoology. December