There are more than 3000 species of snakes in the world. For the purpose of clinical
\npractice, snakes are classifi ed into poisonous (venomous) and non-poisonous (non
\nvenomous) snakes. Poisonous snakes are classifi ed into three families and they are
\n\u2022 Cobra group [Elapidae]
\n\u2022 Viper group [Viperidae]
\n\u2022 Sea snake group [Hydrophidae]
\nFor many decades, the concept of the \u201cBig 4\u201d snakes of medical importance has
\nrefl ected the view that 4 species and responsible for Indian snakebite mortality. They are
\n– the Indian cobra (Naja naja), the Common Krait (Bungarus caeruleus), the Russell\u2019s
\nviper (Daboia russelii) and the Saw scaled viper (Echis carinatus). However, recently
\nanother species, the Hump-nosed pit viper (Hypnale hypnale), has been found to be
\ncapable of causing lethal envenomation, and that this problem had been concealed
\nby systematic misidentifi cation of this species as the saw-scaled viper. The concept
\nof the \u201cBig 4\u201d snakes has failed to include all currently known snakes of medical
\nsignifi cance in India. This has a negative effects on clinical management of snakebite
\nand the development of effective snake anti venoms
\nIn 1981, the W.H.O. developed the following defi nition of snakes of medical
\nimportance (Table No.2). This model is more accurate and useful than defi nitions such
\nas the \u2018Big 4\u2019 that are inaccurate and misleading to doctors and more importantly to
\nASV manufacturers.<\/p>\n
Table No. 2: Categorisation of snakes (W.H.O. 1981)<\/strong><\/p>\n Class Details Name of the snakes<\/strong><\/p>\n King cobra \/ Mountain pitviper<\/td>\n<\/tr>\n Snakes of Medical Importance in Tamil Nadu – Distinguishing There are six medically important species in Tamil Nadu shown above. Readers are There are more than 3000 species of snakes in the world. For the purpose of clinical practice, snakes are classifi ed into poisonous (venomous) and non-poisonous (non venomous) snakes. Poisonous snakes are classifi ed into three families and they are \u2022 Cobra group [Elapidae] \u2022 Viper group [Viperidae] \u2022 Sea snake group [Hydrophidae] For many […]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":21,"menu_order":1,"comment_status":"open","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-27","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/27","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/comments?post=27"}],"version-history":[{"count":0,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/27\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/pages\/21"}],"wp:attachment":[{"href":"https:\/\/doctorbruno.info\/snake-bite-scorpion-sting-protocol\/wp-json\/wp\/v2\/media?parent=27"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n\n
\n I Commonly cause death or serious disability<\/td>\n Russells viper \/ Cobra \/ Saw scaled viper<\/td>\n<\/tr>\n \n II Uncommonly cause bites but are recorded to cause serious effects (death or local necrosis)<\/td>\n Krait \/ Hump-nosed pit viper \/<\/p>\n \n III Commonly cause bites but serious effects are very uncommon.<\/td>\n Water snakes, Green snake<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\nfeatures
\nA great deal is written concerning the problem of how to identify medically
\nsignifi cant species from non signifi cant ones. A large amount of space is devoted, in
\nboth medical and toxicology textbooks, to the problem of how to identify venomous
\nsnakes. The problem with this information is that it is complex (involves counting
\nof scales) and not defi nitive (the identifi cation of pre or post maxillary teeth) and of
\nno use to a doctor in a medical situation. On the question of description, it is worth
\nremembering that the least reliable means of identifying a particular species of snake
\nis to use colour. Virtually every species of venomous snake has a huge range of colour
\nmanifestations and even the markings can be subjected to major variations. What is
\nimportant therefore is to focus on the key aspects of identifi cation that enable the
\nmedical professional to rapidly identify whether they are dealing with a venomous
\nspecies, and what that species might be.<\/p>\n
\ninformed to get familiarised with the pictures given at the end of Hand-book. Further
\ndetails of some of the poisonous snake are provided in the ensuing paragraphs.
\nRussell\u2019s Viper (Daboia russelii)
\nThe Russell\u2019s Viper is a stout bodied snake, the largest of which grows to
\napproximately 1.8 meters in length. Like all the vipers it is a nocturnal snake, but
\nunfortunately for humans, during the daytime it rests up under bushes, at the base of
\ntrees and in leaf litter. It is therefore frequently encountered by rural workers, as they
\nare carrying out general agricultural activities.
\nThere are two key identifi cation features that are worth noting. The fi rst is a series
\nof chain-like or black edged almond shaped marks along the snakes back and fl anks.
\nThe second distinguishing mark is a white triangular mark on the head with the apex
\nof the triangle pointing towards the nostrils.
\nSaw scaled Viper (Echis carinatus)
\nThe southern Indian Saw Scaled Viper is a small snake, usually between 30 and 40
\ncentimetres long. The northern Indian species (Echis sochureki) is much larger, with
\nan average size of 60 centimetres. It inhabits mainly dry arid climates but can also be
\nfound in scrubland.
\nOne of the key identifi cation features of this species is the posture it adopts when
\nit is agitated. It moves its body into a fi gure of eight like arrangement with its head
\nat the centre. It rapidly moves its coils against each other and produces a hissing like
\nsound which gives its name of \u2018Saw Scaled\u2019. In addition, there are often wavy hoop
\nlike markings down both sides of the Saw Scales body. On the head, there is usually
\na white or cream arrow shaped mark, pointing towards the front of the head, often
\ncompared to the shape of a bird\u2019s foot.
\nThe Hump-nosed Pit viper (Hypnale hypnale)
\nThe Hump-nosed pit viper is one of India\u2019s tiniest venomous snakes, its total length
\nranging from 28.5 to 55cm. Its distinctive features include the presence of fi ve large
\nsymmetrical plate scales on the top of the head in addition to the smaller scales typical
\nof all vipers. There are heat sensitive pits between the nostril and the eye.
\nSpectacled Cobra (Naja naja)
\nThe Spectacled Cobra, is probably India\u2019s most well recognised snake. The hood
\nmarkings of the spectacle like mark, distinguishes this snake from other species, and
\nits habit of rearing up when alarmed makes it distinctive but not defi nitive as otherspecies do this, notably the Trinket Snake. The Cobras coloration may vary from pale
\nyellow to black.
\nCommon Krait (Bungarus caeruleus)
\nThe Common Krait is a nocturnal snake which usually grows to approximately
\n1.0 to 1.2 metres in length. Its primary diet is other snakes. It can be found all over
\nPeninsular India and often seeks habitation near human dwellings. During the day it
\nrests up in piles of bricks, rat burrows or other buildings. The Common Krait is the
\nmost poisonous snake in India and its venom is pre-synaptic neurotoxic in nature.
\nThere are a number of key identifi ers which are worth remembering. The Krait
\nis black, sometimes with a bluish tinge, with a white belly. Its markings consist of
\npaired white bands which may be less distinct anteriorly. These paired white bands
\ndistinguish the snake from another black nocturnal snake, the Common Wolf Snake.
\nThe Wolf Snake\u2019s white bands usually are thicker and are singular bands equidistant
\nfrom each other. The second useful distinguishing feature is a series of hexagonal
\nscales along the top of the snakes back. This feature is really useful if the dead snake
\nhas been brought to the hospital and examined.
\nKing Cobra (Ophiophagus hannah)
\nThe King Cobra is the least medically signifi cant of the venomous snakes in India
\nin terms of both bites and fatalities. Hence, descriptive features of this are not provided
\nhere<\/p>\n","protected":false},"excerpt":{"rendered":"