Pathmeswaran et al developed a score that can help to identify the source of a snakebite. The authors are from University of Kelaniya in Sri Lanka and Liverpool School of Tropical Medicine.
Snakes seen in Sri Lanka:
(1) cobra
(2) Russell’s viper
(3) Krait
(4) hump-nosed or saw-scaled viper (showed similar findings)
Snake |
Bite in Daytime |
Bite in Evening to 11 PM |
Bite at Night After 11 PM to Dawn |
cobra |
2 |
1 |
-1 |
Russell’s viper |
1 |
2 |
-1 |
Krait |
-2 |
-1 |
2 |
HN or SS viper |
1 |
2 |
-1 |
Snake |
Bite Inside Dwelling |
Bite in Garden or Home Compound |
Bite Elsewhere Outdoors |
cobra |
1 |
1 |
1 |
Russell’s viper |
-1 |
1 |
1 |
Krait |
2 |
-2 |
-2 |
HN or SS viper |
-2 |
2 HN, 1 SS |
2 |
Snake |
Bitten on Trunk |
Bitten Distal Limb |
Bitten Proximal Limb |
Bitten Elsewhere |
cobra |
-2 |
2 |
1 |
-1 |
Russell’s viper |
-2 |
2 |
-1 |
-1 |
Krait |
2 |
1 |
1 |
2 |
HN or SS viper |
-2 |
2 |
-1 |
-2 |
Snake |
Swelling |
Necrosis |
Abdominal Pain |
Hemorrhage |
cobra |
1 |
2 |
0 |
-1 |
Russell’s viper |
2 |
-1 |
-2 |
2 |
Krait |
-1 |
-4 |
2 |
-4 |
HN or SS viper |
2 |
-1 |
-2 |
-2 |
Snake |
Neurotoxicity |
Respiratory Paralysis |
Renal Failure |
cobra |
2 |
1 |
-1 |
Russell’s viper |
2 |
-1 |
-2 |
Krait |
2 |
2 |
-4 |
HN or SS viper |
-2 |
-2 |
-2 |
total score =
= SUM(points for each type of snake)
Specialty: Toxicology, Emergency Medicine, Critical Care