Factors that influence the clinical severity of venomous snakebites in Southern California

Analysis of the venomous snakebite patients treated in the Uzice General Hospital (Western Serbia) between 2006 and 2018

“…According to the physicians' notes, all bites we analyzed were legitimate (hazardous), often occupational, contrary to some previous reports [15,16] and our suspicions. Illegitimate bites (by the snakes which are observed in time but are provoked/irritated intentionally), although highly probable in natural surroundings, often are inflicted by captive, sometimes exotic species and can result in more severe envenomation compared to bites on laymen by autochthonous snakes [27,28]. Judging solely by the frequencies of bitten persons and locations of the bites in various environments/activities, we suppose that those engaged in some agricultural work either did not see the snakes or tried to remove them by hand hence significantly more bites to upper extremities.…”

Interfang Distances of Rattlesnakes: Sexual, Interspecific, and Body Size-related Variation, and Implications for Snakebite Research and Management

“…These species also inflict a substantial number of bites in southern California, where clinicians often treat bites from multiple species. [2][3][4][5][6] Our sample included both long-term captives and recently captured specimens, all from southern California locations with the exception of 2 C cerastes from Arizona. We assumed that husbandry exerted a negligible effect on the kinematics of fang use, and therefore included all snakes in our analyses.…”

“…7 –10 Knowing the size of the envenoming snake has significant predictive value for overall clinical severity, symptom progression, and the amount of antivenom needed to treat a bite. 4 –6…”

“…Of these factors, size of the snake (along with size of the patient) may have the greatest effect on envenomation severity. Hospital-based studies have consistently shown that larger snakes cause more severe bites [2][3][4][5][6] because they inject larger quantities of venom. [7][8][9][10] Knowing the size of the envenoming snake has significant predictive value for overall clinical severity, symptom progression, and the amount of antivenom needed to treat a bite.…”

“…[7][8][9][10] Knowing the size of the envenoming snake has significant predictive value for overall clinical severity, symptom progression, and the amount of antivenom needed to treat a bite. [4][5][6] Since knowledge of the size of the envenoming snake may be of use to clinicians, and because the perceived size of the snake reported by patients or other witnesses may be unreliable (or unavailable if the patient is unconscious), a more objective means of determining snake size in a clinical setting would be desirable. One potential method is to use the distance between the wounds caused by the fangs (ie, fang spread or interfang distance) to estimate snake size.…”