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Ophiophagus hannah
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Ophiophagus hannah  ( King Cobra )  [ Original photo copyright © Dr Julian White ]
Family: Elapidae
Subfamily: Elapinae
Genus: Ophiophagus
Species: hannah
Common Names
King Cobra , Hamadryad , Jungle Cobra
Local Names
Taw-Gyi Mwe Haut , Yanjing Wang She , Ular Tedong Selar , Ular Kunyet Terus , Ular Tedong Belalang , Ular Anang , Oraj Totok , Ular Tedung , Tomumuho , Mantakah , Belalang
Region
Indian Sub-continent + North Asia + Southeast Asia
Countries
Bangladesh, Bhutan, Brunei, Cambodia, China, Hong Kong, Indonesia, India, Laos, Malaysia, Myanmar, Nepal, Philippines, Singapore, Thailand, Vietnam, Tibet
 
Taxonomy and Biology
Adult Length: 2.00 m
General Shape
Very large in length, tapering, slender bodied snake, withmedium to moderately long tail. Capable of extending the neck region into a long and narrow hood. World's largest venomous snake. Can grow to a maximum of about 5.85 metres ( but rarely found to exceed 4.30 metres ). Head is moderately short, flattened, moderately distinct from neck, with a broad, rounded snout and an indistinct canthus. Eyes are medium in size with round pupils. Dorsal scales are smooth and oblique with anterior vertebral row and outer 2 scale rows enlarged, posterior portion of body often with the middle 3 rows enlarged. Dorsal scale count ( 19 or 17 ) - 15 - 15 ( 13 ).
Habitat
Wide range of habitats. Jungle and primary and secondary forest, woodlands, open fields and foothills at elevations up to about 1800 metres.
Habits
Cannibalistic, terrestrial and diurnal. Non-aggressive and will escape to cover if disturbed but does have a reputation for aggression when brooding. Fearless snake which will not hesitate to stand its ground If provoked or cornered. It will raise its forebody high off the ground and spread its hood and make a growling-like noise in defense.
Prey
Feeds almost entirely on snakes, occasionally lizards.
Species Map
Small (Approx 20k) version
 
Venom
Average Venom Qty
421 mg ( dry weight of milked venom ), Broad et al (1979). ( Ref : R000006 ).

350 to 500 mg ( dry weight ), Minton (1974) ( Ref : R000504 ).

101.9 mg ( dry weight ), Gopalakrishnakone and Chou (1990) ( Ref : R000004 ) p 255.
Preferred LD50 Estimate
1.80 mg / kg sc ( mice ), Broad et al (1979) ( Ref : R000006 ) in Gopalakrishnakone and Chou (1990) ( Ref : R000004 ).
General: Venom Neurotoxins
Postsynaptic neurotoxins
General: Venom Myotoxins
Probably not present
General: Venom Procoagulants
Probably not present
General: Venom Anticoagulants
Probably not present
General: Venom Haemorrhagins
Probably not present
General: Venom Nephrotoxins
Probably not present
General: Venom Cardiotoxins
Probably not present
General: Venom Necrotoxins
Possibly present
General: Venom Other
Unknown
 
Clinical Effects
General: Dangerousness
Severe envenoming likely, high lethality potential
General: Rate of Envenoming: >80%
General: Untreated Lethality Rate: 50-60%
General: Local Effects
Marked local effects; pain, severe swelling, necrosis
General: Local Necrosis
Uncommon but can be moderate to severe
General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, dizziness, collapse or convulsions
General: Neurotoxic Paralysis
May cause moderate to severe flaccid paralysis
General: Myotoxicity
Does not occur, based on current clinical evidence
General: Coagulopathy & Haemorrhages
Does not occur, based on current clinical evidence
General: Renal Damage
Does not occur, based on current clinical evidence
General: Cardiotoxicity
Does not occur, based on current clinical evidence
General: Other
Unknown
 
First Aid
Description: First aid for bites by Elapid snakes which do not cause significant injury at the bite site (see Comments for partial listing), but which may have the potential to cause significant general (systemic) effects, such as paralysis, muscle damage, or bleeding.
Details
1. After ensuring the patient and onlookers have moved out of range of further strikes by the snake, the bitten person should be reassured and persuaded to lie down and remain still. Many will be terrified, fearing sudden death and, in this mood, they may behave irrationally or even hysterically. The basis for reassurance is the fact that many venomous bites do not result in envenoming, the relatively slow progression to severe envenoming (hours following elapid bites, days following viper bites) and the effectiveness of modern medical treatment.
2. The bite wound should not be tampered with in any way. Wiping it once with a damp cloth to remove surface venom is unlikely to do much harm (or good) but the wound must not be massaged. For Australian snakes only, do not wash or clean the wound in any way, as this may interfere with later venom detection once in a hospital.
3. All rings or other jewellery on the bitten limb, especially on fingers, should be removed, as they may act as tourniquets if oedema develops.
4. If the bite is on a limb, a broad bandage (even torn strips of clothing or pantyhose) should be applied over the bitten area at moderate pressure (as for a sprain; not so tight circulation is impaired), then extended to cover as much of the bitten limb as possible, including fingers or toes, going over the top of clothing rather than risking excessive limb movement by removing clothing. The bitten limb should then be immobilised as effectively as possible using an extemporised splint or sling.
5. If there is any impairment of vital functions, such as problems with respiration, airway, circulation, heart function, these must be supported as a priority. In particular, for bites causing flaccid paralysis, including respiratory paralysis, both airway and respiration may be impaired, requiring urgent and prolonged treatment, which may include the mouth to mask (mouth to mouth) technique of expired air transfer. Seek urgent medical attention.
6. Do not use Tourniquets, cut, suck or scarify the wound or apply chemicals or electric shock.
7. Avoid peroral intake, absolutely no alcohol. No sedatives outside hospital. If there will be considerable delay before reaching medical aid, measured in several hours to days, then give clear fluids by mouth to prevent dehydration.
8. If the offending snake has been killed it should be brought with the patient for identification (only relevant in areas where there are more than one naturally occurring venomous snake species), but be careful to avoid touching the head, as even a dead snake can envenom. No attempt should be made to pursue the snake into the undergrowth as this will risk further bites.
9. The snakebite victim should be transported as quickly and as passively as possible to the nearest place where they can be seen by a medically-trained person (health station, dispensary, clinic or hospital). The bitten limb must not be exercised as muscular contraction will promote systemic absorption of venom. If no motor vehicle or boat is available, the patient can be carried on a stretcher or hurdle, on the pillion or crossbar of a bicycle or on someone's back.
10. Most traditional, and many of the more recently fashionable, first aid measures are useless and potentially dangerous. These include local cauterization, incision, excision, amputation, suction by mouth, vacuum pump or syringe, combined incision and suction ("venom-ex" apparatus), injection or instillation of compounds such as potassium permanganate, phenol (carbolic soap) and trypsin, application of electric shocks or ice (cryotherapy), use of traditional herbal, folk and other remedies including the ingestion of emetic plant products and parts of the snake, multiple incisions, tattooing and so on.
 
Treatment
Treatment Summary
Bites can cause both local tissue injury and systemic effects, principally flaccid paralysis. Treatment is therefore twofold; good wound care and control of secondary infection, plus watch for flaccid paralysis. If severe paralysis present, with respiratory failure, requires intubation & ventilation. Specific antivenoms available, which should be given at first sign of developing paralysis.
Key Diagnostic Features
Local pain, swelling, blistering, necrosis ± flaccid paralysis
General Approach to Management
All cases should be treated as urgent & potentially lethal. Rapid assessment & commencement of treatment including appropriate antivenom (if indicated & available) is mandatory. Admit all cases.
Antivenom Therapy
Antivenom is the key treatment for systemic envenoming. Multiple doses may be required.
Antivenoms
1. Antivenom Code: SAsCRI01
Antivenom Name: Polyvalent Anti Snake Venom Serum
Manufacturer: Central Research Institute
Phone: ++91-1-792-72114
Address: Kasauli (H.P.) 173204
Country: India
2. Antivenom Code: SAsTRC03
Antivenom Name: King Cobra Antivenin
Manufacturer: Science Division, Thai Red Cross Society
Phone: ++66-2-252-0161 (up to 0164)
Address: Queen Saovabha Memorial Institute
1871 Rama IV Road
Pathumwan
Bangkok 10330
Country: Thailand
3. Antivenom Code: SAsVRU06
Antivenom Name: Ophiophagus hannah Antivenom
Manufacturer: Venom Research Unit
Address: University of Medicine and Pharmacy
Ho Chi Minh City
217 An Duong Vuong Q5
Country: Vietnam
4. Antivenom Code: SAsSII01
Antivenom Name: SII Polyvalent Antisnake Venom Serum ( lyophilized )
Manufacturer: Serum Institute of India Ltd.
Phone: +91-20-26993900
Address: 212/2, Hadapsar,
Off Soli Poonawalla Road,
Pune-411042. India
Country: India
Ophiophagus hannah ( King Cobra ) [ Original photo copyright © Dr Julian White ]
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Ophiophagus hannah ( King Cobra ) [ Original photo copyright © Dr Julian White ]
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Ophiophagus hannah ( King Cobra ) [ Original photo copyright © Dr Wolfgang Wuster - Thailand]
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