Family: Viperidae
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Subfamily: Crotalinae
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Genus: Gloydius
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Species: himalayanus
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Common Names
Himalayan Pit Viper
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Region
West Asia + Indian Sub-continent
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Countries
India, Nepal, Pakistan
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Taxonomy and Biology
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Adult Length: 0.45 m
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General Shape
Small in length, medium bodied snake with a short and rapidly tapering tail. Can grow to a maximum of about 0.86 metres. Head is broad, flattened, triangular and distinct from neck. Snout is blunt. Eyes are medium in size with vertically elliptical pupils. Dorsal scales are strongly keeled. Dorsal scale count ( 20 to 23 ) - 21 ( 19 to 23 ) - 17 ( 15 ).
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Habitat
Highland dweller ( both rocky and forested regions, especially conifer forest ) between about 1500 and 4950 metres. Takes refuge under fallen timber, rock crevices, under rocks, boulders, rock overhangs and ledges.
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Habits
Diurnal and terrestrail snake rarely venturing far from its daytime retreat. It is a timid, somewhat lazy and slow moving snake. If disturbed it will escape to its retreat. Will not attempt to bite when handled.
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Prey
Feeds mainly on small rodents, millipedes and centipedes.
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Venom
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General: Venom Neurotoxins
Possibly present
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General: Venom Myotoxins
Possibly present
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General: Venom Procoagulants
Possibly present
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General: Venom Anticoagulants
Probably not present
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General: Venom Haemorrhagins
Possibly present
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General: Venom Nephrotoxins
Probably not present
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General: Venom Cardiotoxins
Probably not present
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General: Venom Necrotoxins
Possibly present
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General: Venom Other
Unknown
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Clinical Effects
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General: Dangerousness
Unknown, but potentially lethal envenoming, though unlikely, cannot be excluded.
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General: Rate of Envenoming: Unknown but likely to be moderate
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General: Untreated Lethality Rate: Unknown but lethal potential cannot be excluded
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General: Local Effects
Local pain, swelling, bruising & blistering
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General: Local Necrosis
Insufficient clinical reports to know
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General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, dizziness, collapse or convulsions
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General: Neurotoxic Paralysis
No clinical reports for this species, but related species cause flaccid paralysis
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General: Myotoxicity
No case reports for this species, but related species may cause systemic myolysis
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General: Coagulopathy & Haemorrhages
No reports of coagulopathy, though related species can cause bleeding problems
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General: Renal Damage
No case reports for this species, but related species can cause renal failure.
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General: Cardiotoxicity
Does not occur, based on current clinical evidence
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General: Other
Shock secondary to fluid shifts due to local tissue injury is likely in severe cases
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First Aid
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Description: First aid for bites by Viperid snakes likely to cause significant local injury at the bite site (see listing in Comments section).
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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. 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. The bitten limb should be immobilised as effectively as possible using an extemporised splint or sling; if available, crepe bandaging of the splinted limb is an effective form of immobilisation. 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.
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Treatment
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Treatment Summary
Himalayan pit viper bites cause local ± systemic effects. Urgently assess, admit, IV fluids, supportive & symptomatic treatment. No specific antivenom available.
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Key Diagnostic Features
Local pain, swelling, blistering, necrosis + coagulopathy, bleeding, renal failure
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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.
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Antivenom Therapy
Only antivenoms available are for related species, but should be used for significant envenoming
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