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Bothrops atrox
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Bothrops atrox  ( Common Lancehead )  [ Original photo copyright © Dr Wolfgang Wuster - Brazil ]
Family: Viperidae
Subfamily: Crotalinae
Genus: Bothrops
Species: atrox
Common Names
Common Lancehead , Barba Amarilla , Mapanare , Caissaca , Fer-de-lance
Local Names
Acuamboia , Ala , Aroani , Bergimaka , Bula , Cacutali , Caicaca , Caissaca , Cambeua , Cascabel , Comboia , Cuaima Parda , Cuamboia , Equis , Cuatronarices , Guyanesa , Ihdoni , Jararaca , Jararaca do Norte , Jararaca-do-rabo-branco , Jararaca Grao de Arroz , Jergon , Jergona , Jergon de la Selva , Juba-vitu , Karahirima , Labaria , Labarri , Labarriayre , Lanspuntslang , Macanchi , Machacu , Macubuleru , Mapana , Mapanare , Mapanare Guayanesa , Mapanare de Carabobo , Mapanare Terciopelao, Mapepire Balsain , Marashar , Mata Caballo , Montanosa , Nacarita , Nashipkit , Nenenenca , Owroekoekoe , Petjake , Pialala , Pitalala , Pudridora , Putrificador , Rabo Amarillo , Rabo de Candela , Rasper , Sahru-ima , Sororaima , Taya , Taya Equis , Terciopelo , Yopperojobobo Venosa
Region
South America
Countries
Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Peru, Suriname, Trinidad and Tobago, Venezuela
 
Taxonomy and Biology
Adult Length: 0.80 m
General Shape
Medium to large in length, moderately heavy bodied pitviper with a short tail. Can grow to a maximum of about 1.80 metres. Head is broad, flattened, lance shaped when viewed from above and distinct from narrow neck. Snout is not elevated. Eyes are medium in size with vertically elliptical pupils. Dorsal scales are keeled. Dorsal scale count usually ( 21 to 27 ) - ( 23 or 25 ) - ( 19 to 21 ).
Habitat
Rainforest, lower montane wet forest, savanna gallery forest and tropical deciduous forest. Frequently encountered in cultivated areas and human settlements ( including urban fringes ) near close proximity to rivers, streams or lakes.
Habits
Terrestrial and mainly a nocturnal snake, spending the day hidden among roots, leaf litter or other similar locations. Fast moving snake which will defend itself vigorously if disturbed.
Prey
Juveniles tend to feed on small vertebrates. Adults feed mainly on small mammals but will eat lizards, snakes, birds and frogs.
Species Map
Small (Approx 20k) version
 
Venom
Average Venom Qty
70 to 160 mg ( dry weight ), U.S. Dept. Navy (1968) ( Ref : R000914 ).

150 to 300 mg ( dry weight ), Minton (1974) ( Ref : R000504 ).

Para, Brazil : 120 mg ( dry weight ) ( range 64 to 176 ), Sanchez et al (1992) ( Ref : R000690 ).
General: Venom Neurotoxins
Probably not present
General: Venom Myotoxins
Systemic myotoxins present
General: Venom Procoagulants
Prothrombin convertors
General: Venom Anticoagulants
Probably not present
General: Venom Haemorrhagins
Zinc metalloproteinase
General: Venom Nephrotoxins
Possibly 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: Unknown, but possibly >80%
General: Untreated Lethality Rate: Unknown but may cause major envenoming
General: Local Effects
Marked local effects; pain, severe swelling, bruising, blistering, necrosis, abscess formation
General: Local Necrosis
Potentially may occur
General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, dizziness, collapse or convulsions
General: Neurotoxic Paralysis
Does not occur, based on current clinical evidence
General: Myotoxicity
Insufficient clinical reports to know
General: Coagulopathy & Haemorrhages
Common, moderate to severe coagulopathy + haemorrhagins causing extensive bleeding
General: Renal Damage
No case reports for this species, but related species can cause renal failure secondary to coagulopathy.
General: Cardiotoxicity
Does not occur, based on current clinical evidence
General: Other
Shock secondary to fluid shifts due to local tissue injury is likely in severe cases
 
First Aid
Description: First aid for bites by Viperid snakes likely to cause significant local injury at the bite site (see listing in Comments section).
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.
 
Treatment
Treatment Summary
This treatment advice is general for most Bothrops species. Bites will vary from minor to life threatening. Therefore manage all bites as potentially major. Look for moderate to severe local effects, including pain, swelling, potential for fluid shifts and hypovolaemic shock, blistering, necrosis, abscess formation. Systemic effects may be minor or severe, possibly including coagulopathy and bleeding, kidney damage, even myolytic muscle damage. All cases with significant systemic effects require IV antivenom, as will most cases with significant local effects.
Key Diagnostic Features
Local swelling, blistering, necrosis + coagulopathy, bleeding
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: SAmICP01
Antivenom Name: Polyvalent Antivenom
Manufacturer: Instituto Clodomiro Picado
Phone: ++506-2511-7888
Address: Contiguo a la plaza de deportes,
Dulce Nombre de Coronado.
San José
Costa Rica
Country: Costa Rica
2. Antivenom Code: SAmIBB03
Antivenom Name: Soro antibotropico-laquetico
Manufacturer: Instituto Butantan
Phone: +55-11-3726-7222
Address: Av. Vital Brasil, 1500 Butanta
05503-900
Sao Paulo - SP
Country: Brazil
3. Antivenom Code: SAmIBB05
Antivenom Name: Soro botropico
Manufacturer: Instituto Butantan
Phone: +55-11-3726-7222
Address: Av. Vital Brasil, 1500 Butanta
05503-900
Sao Paulo - SP
Country: Brazil
4. Antivenom Code: SAmFED01
Antivenom Name: Soro Antibotropico
Manufacturer: Fundacao Ezequiel Dias - FUNED
Phone: ++55-31-3371-9525
Address: Rua Conde Pereira Carneiro, 80 - Gameleria
Belo Horizonte, MG - CEP 30510-010
Country: Brazil
5. Antivenom Code: SAmFED02
Antivenom Name: Soro Anti-botropico-crotalico
Manufacturer: Fundacao Ezequiel Dias - FUNED
Phone: ++55-31-3371-9525
Address: Rua Conde Pereira Carneiro, 80 - Gameleria
Belo Horizonte, MG - CEP 30510-010
Country: Brazil
6. Antivenom Code: SAmFED04
Antivenom Name: Soro Antibotropico-laquetico
Manufacturer: Fundacao Ezequiel Dias - FUNED
Phone: ++55-31-3371-9525
Address: Rua Conde Pereira Carneiro, 80 - Gameleria
Belo Horizonte, MG - CEP 30510-010
Country: Brazil
7. Antivenom Code: SAmCBV01
Antivenom Name: Suero Antiofidico polyvalente
Manufacturer: Centro de Biotecnologia
Phone: ++58-212-605-2704
Address: Faculta de Farmacia,
Universidad Central de Venezuela
Av. Principal de Los Llustres
Los Caguaramos
Caracas,
Country: Venezuela
8. Antivenom Code: SAmINP01
Antivenom Name: Suero Antibotropico Polivalente
Manufacturer: Instituto Nacional de Salud
Phone: ++51-1-467-4499
Address: Centro Nacional de Produccion de Biologicos
Av. Defensores del Morro 2268
Chorrillos
Lima 9
Country: Peru
9. Antivenom Code: SAmIBB07
Antivenom Name: Soro antibotropico-crotalico
Manufacturer: Instituto Butantan
Phone: +55-11-3726-7222
Address: Av. Vital Brasil, 1500 Butanta
05503-900
Sao Paulo - SP
Country: Brazil
10. Antivenom Code: SAmIBM06
Antivenom Name: Antivipmyn
Manufacturer: Instituto Bioclon
Phone: ++56-65-41-11
Address: Calzada de Tlalpan No. 4687
Toriello Guerra
C.P. 14050
Mexico, D.F.,
Country: Mexico
11. Antivenom Code: SAmLBP01
Antivenom Name: Anti : Bothopicos - Lachesicos - Crotalicos
Manufacturer: Laboratorios Biologicos PROBIOL Ltda.
Phone: +571-6773057, +571-6711023
Address: Sandafe de Bogota
Country: Colombia
12. Antivenom Code: SAmNIC02
Antivenom Name: Antibothropic-Anticrotalic Polyvalent
Manufacturer: Instituto Nacional de Salud
Phone: ++571-220-7700
Address: Av. Eldorado con Carrera,
Zona G,
Bogota D.E.,
Country: Colombia
Bothrops atrox ( Common Lancehead ) [ Original photo copyright © Dr Wolfgang Wuster - Brazil ]
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Bothrops atrox ( Common Lancehead ) [ Original photo copyright © Dr Wolfgang Wuster - Ecuador ]
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Bothrops atrox ( Common Lancehead ) [ Original photo copyright © Dr Wolfgang Wuster - Venezuela ]
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Bothrops atrox ( Common Lancehead ) [ Original photo copyright © Dr Julian White ]
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Bothrops atrox ( Common Lancehead ) [ Original photo copyright © Franck Principaud]
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Bothrops atrox ( Common Lancehead ) [ Original photo copyright © Dr Jurg Meier ]
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