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Acanthophis praelongus
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Acanthophis praelongus  ( Northern Death Adder  )  [ Original photo copyright © Dr Julian White ]
Family: Elapidae
Subfamily: Elapinae
Genus: Acanthophis
Species: praelongus
Common Names
Northern Death Adder
Region
Australia
Countries
Australia
 
Taxonomy and Biology
Adult Length: 0.45 m
General Shape
Small in length, short, moderately stout, stumpy bodied snake (but more elongate than A. antarcticus), with a medium length, slender rat-like tail terminating in a sharp, soft and curved spine. Can grow to a maximum of about 0.89 metres. Viper-like in appearance with a broad, triangular head, pronounced brow ridge and head is distinct from the very narrow neck. Eyes are medium in size with vertically elliptical pupils. Body and head scales are moderately keeled. Generally intermediate in rugosity of head shields (moderately to strongly rugose), keeling of dorsal scales, ventral and subcaudal scale counts when compared with A. antarcticus and A. pyrrhus. Dorsal scale count (19 or 21) - 23 (21) - 17 (19).
Habitat
Australia : Plains, slopes and ranges in tropical woodland, tropical forest, shrubland or grassland.
Habits
Nocturnal, terrestrial and secretive. If disturbed they tend to rely on their camouflage and remain still. If provoked it will flatten its body in a coiled position and strike rapidly. If this fails it will resort to escape. It twitches its tail in leaf litter, close to its head, to attract potential prey to within striking distance. The rustling sound, insect like movement and pale coloured tail tip is an effective lure. Shelters in deep fixed leaf litter, usually near or under low bush or large boulders offering shade.
Prey
Juveniles tend to feed mainly on small lizards, particularly skinks. Adults feed mainly on lizards, small mammals and birds and occasionally frogs.
Species Map
Small (Approx 20k) version
 
Venom
Average Venom Qty
49.5 mg ( dry weight of milked venom ), Gopalakrishnakone and Chou (1990) ( Ref : R000004 ).
General: Venom Neurotoxins
Pre- & Post-synaptic neurotoxins
General: Venom Myotoxins
Possibly present
General: Venom Procoagulants
Not present
General: Venom Anticoagulants
Possibly present but not clinically significant
General: Venom Haemorrhagins
Not present
General: Venom Nephrotoxins
Not present
General: Venom Cardiotoxins
Not present
General: Venom Necrotoxins
Not present
General: Venom Other
Not present or not significant
 
Clinical Effects
General: Dangerousness
Severe envenoming possible, potentially lethal
General: Rate of Envenoming: 40-60%
General: Untreated Lethality Rate: 50-60%
General: Local Effects
Local pain & swelling
General: Local Necrosis
Not likely to 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
Very common, flaccid paralysis is major clinical effect
General: Myotoxicity
Not likely to occur
General: Coagulopathy & Haemorrhages
Unlikely to occur
General: Renal Damage
Unlikely to occur
General: Cardiotoxicity
Unlikely to occur
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
Death adder bites have a high potential for major envenoming (paralysis), so all cases require urgent assessment. At first sign of developing paralysis, give antivenom.
Key Diagnostic Features
Local pain + 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: SAuCSL07
Antivenom Name: Death Adder Antivenom
Manufacturer: CSL Limited
Phone: ++61-3-9389-1911
Toll free: 1800 642 865
Address: 45 Poplar Road
Parkville
Victoria 3052
Country: Australia
2. Antivenom Code: SAuCSL12
Antivenom Name: Polyvalent Snake Antivenom ( Australia - New Guinea )
Manufacturer: CSL Limited
Phone: ++61-3-9389-1911
Toll free: 1800 642 865
Address: 45 Poplar Road
Parkville
Victoria 3052
Country: Australia
Acanthophis praelongus ( Northern Death Adder ) [ Original photo copyright © Dr Julian White ]
Larger version
 
Acanthophis praelongus ( Northern Death Adder ) [ Original photo copyright © Dr Julian White ]
Larger version
 
Acanthophis praelongus ( Northern Death Adder ) [ Original photo copyright © Dr Julian White ]
Larger version
 
Acanthophis praelongus ( Northern Death Adder ) [ Original photo copyright © Dr Julian White ]
Larger version
 
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