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Bothrops jararacussu
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Bothrops jararacussu  ( Jararacussu  )  [ Original photo copyright © Dr Wolfgang Wuster ]
Family: Viperidae
Subfamily: Crotalinae
Genus: Bothrops
Species: jararacussu
Common Names
Jararacussu
Local Names
Cabeca de Sapo , Jararacucu , Jararacucu Malha de Sapo , Jararacucu Tapete , Jararacucu Verdadeiro , Kiririog-saiyu , Patrona , Surucucu Apete , Surucucu Dourado , Surucucu Tapete , Urutu Amarelo , Urutu Dourado , Urutu Estrela , Urutu Preto , Yarara-cussu , Yarara Dorada , Yarara-guasu , Yarara-guazu ,Yope Pintada , Yoperojobobo Venenosa
Region
South America
Countries
Argentina, Bolivia, Brazil, Paraguay
 
Taxonomy and Biology
Adult Length: 0.90 m
General Shape
Large in length, heavy bodied pitviper. Can grow to a maximum of over 2.20 metres. Head is relatively large, 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 strongly keeled.
Habitat
Tropical rainforest, tropical semi-deciduous forest, evergreen forest and pine forest in swamp or low lying regions.
Habits
Terrestrial and mainly a nocturnal snake.
Prey
Feeds mainly on rodents and frogs,
Species Map
Small (Approx 20k) version
 
Venom
Average Venom Qty
100 to 200 mg ( dry weight ), Minton (1974) ( Ref : R000504 ).

Female ( n=21 ) = 583 mg, Newborn = 47 mg. Furtado et al (1991) ( Ref : R000651 ).

Minas Gerais, Brazil : 247 mg ( dry weight ) ( range 149 to 385 ), Sanchez et al (1992) ( Ref : R000690 ).

Argentina : 181.0 ± 8 mg ( dry weight ) = 60.57 ± 2.84 mg venom / 100 g body weight, De Roodt et al (1988) ( Ref : R000870 ).
General: Venom Neurotoxins
Probably not present
General: Venom Myotoxins
Systemic myotoxins present, but principally cause local myonecrosis
General: Venom Procoagulants
Fibrinogen clotting toxins
General: Venom Anticoagulants
Probably not present
General: Venom Haemorrhagins
Probably present
General: Venom Nephrotoxins
Possibly present
General: Venom Cardiotoxins
Probably not present
General: Venom Necrotoxins
Present but not defined
General: Venom Other
Unknown
 
Clinical Effects
General: Dangerousness
Severe envenoming possible, potentially lethal
General: Rate of Envenoming: Probably >80%, at least for specimens >50 cm long.
General: Untreated Lethality Rate: 1-10%
General: Local Effects
Marked local effects; pain, severe swelling, bruising, blistering, necrosis, abscess formation
General: Local Necrosis
Common, 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
Does not occur, based on current clinical evidence
General: Myotoxicity
Uncommon to rare, but may be moderate to severe
General: Coagulopathy & Haemorrhages
Very common, coagulopathy + haemorrhagins causing bleeding is major clinical effect
General: Renal Damage
Common, usually secondary effect
General: Cardiotoxicity
Uncommon, secondary to myolysis-induced hyperkalaemia
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: SAmNIA02
Antivenom Name: Antibothrops Tetravalente
Manufacturer: Instituto Nacional de Produccion de Biologics
A.N.L.I.S.
Phone: ++54-11-4303-1806 (to 11)
Address: Avdo. Velez Sarsfield 563,
CP 1281 Buenos Aires,
Country: Argentina
8. 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
9. 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
Bothrops jararacussu ( Jararacussu ) [ Original photo copyright © Dr Wolfgang Wuster ]
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Bothrops jararacussu ( Jararacussu ) [ Original photo copyright © Dr Wolfgang Wuster ]
Larger version
 
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