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History

Key elements in a snakebite history are:

  • Time and place of definite or possible exposure to a snake.
  • Description of a snake, if seen (colour, size).
  • Number of times bitten (multiple bites are usually more severe).
  • Was the bite through clothing, which might make the bite less effective.
  • What type of first aid was used, how long after the bite, and how active was the patient after the bite?
  • What symptoms has the patient experienced since the bite; specifically ask about local pain, swelling, blistering, bleeding from the bite, systemic features including headache, nausea, vomiting, abdominal pain, dizziness, collapse, convulsions, “sleepy eyes” (ptosis), dysarthria, dysphagia, respiratory distress, dark urine (myoglobinuria), persistent bleeding from the bite site or elsewhere (coagulopathy).
  • Relevant past history, particularly renal problems, bleeding disorders.
  • Medications, particularly anticoagulants, NSAIDS or other platelet active drugs, beta blockers or ACE inhibitors.
  • Allergies, particularly to horses.