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Crotalus durissus
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Family: Viperidae
Subfamily: Crotalinae
Genus: Crotalus
Species: durissus
Subspecies: dryinas (Note that this taxon is without uniform recognition by taxonomists)
Common Names
( subsp. dryinas ) Neotropical Rattlesnake
Local Names
Cascabel , Cascabela ,Vibora de Cascabel
Region
South America
Countries
Brazil, French Guiana, Guyana, Suriname
 
Taxonomy and Biology
Adult Length: 0.90 m
General Shape
Large in length, stout bodied rattlesnake with a short tail and a horn-like segmented rattle. Can grow to a maximum of about 1.51 metres. Head is large, broad and very distinct from narrow neck. Eyes are medium to moderately small in size with vertically elliptical pupils. Spinal ridge is evident, particularly anteriorly, and dorsal scales are strongly keeled and tuberculate.
Habitat
Elevations up to about 700 metres. Mainly semi-arid regions, dry tropical forest, thorn forest, pine-oak forest, savanna woodland and scrub.
Habits
Terrestrial and diurnal snake.
Prey
Feeds mainly on lizards, rodents, small mammals and birds.
Species Map
Small (Approx 20k) version
 
Venom
General: Venom Neurotoxins
No data but likely to be similar to related species (C.d.terrificus)
General: Venom Myotoxins
No data but likely to be similar to related species (C.d.terrificus)
General: Venom Procoagulants
No data but likely to be similar to related species (C.d.terrificus)
General: Venom Anticoagulants
No data but likely to be similar to related species (C.d.terrificus)
General: Venom Haemorrhagins
No data but likely to be similar to related species (C.d.terrificus)
General: Venom Nephrotoxins
No data but likely to be similar to related species (C.d.terrificus)
General: Venom Cardiotoxins
No data but likely to be similar to related species (C.d.terrificus)
General: Venom Necrotoxins
No data but likely to be similar to related species (C.d.terrificus)
General: Venom Other
No data but likely to be similar to related species (C.d.terrificus)
 
Clinical Effects
General: Dangerousness
Clinical effects uncertain, but related to medically important species, therefore major envenoming cannot be excluded.
General: Rate of Envenoming: Unknown
General: Untreated Lethality Rate: Unknown but lethal potential cannot be excluded
General: Local Effects
Insufficient clinical reports to know, but most likely minor local pain & swelling only
General: Local Necrosis
Insufficient clinical reports to know, but most likely does not occur
General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, tachypnoea, respiratory distress, hypotension, dizziness, collapse or convulsions
General: Neurotoxic Paralysis
No clinical reports for this species, but related species cause flaccid paralysis
General: Myotoxicity
No case reports for this species, but related species can cause systemic myolysis
General: Coagulopathy & Haemorrhages
Insufficient clinical reports to know, but moderate coagulopathy, even defibrination can occur in at least some cases
General: Renal Damage
Recognised complication, usually secondary to myolysis
General: Cardiotoxicity
No case reports for this species, but related species can cause hyperkalaemic cardiotoxicity secondary to myolysis.
General: Other
Insufficient clinical reports to know
 
First Aid
Description: First aid for bites by Viperid snakes not likely to cause significant injury at the bite site or where general (systemic) effects are likely to be more important than local effects (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. 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. In Australia and parts of New Guinea, Snake Venom Detection Kits are available to identify the snake from venom left on the skin.
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 by species showing the South American rattlesnake clinical pattern are quite different from North American rattlesnake bites. The bite may cause few if any local effects, but can cause severe, even lethal systemic effects, particularly paralysis & myolysis (coagulopathy also possible). Therefore every case must be admitted at least overnight and closely observed. Should any evidence of paralysis or myolysis develop, antivenom is the principal treatment. Specific antivenoms exist for several major species.
Key Diagnostic Features
Minimal to mild local reaction + flaccid paralysis, myolysis, sometimes 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: 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
2. Antivenom Code: SAmFED03
Antivenom Name: Soro Anticrotalico
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
3. 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
4. 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
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