Dawaa Reference

acute

Snake Bite

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources1 source

WHO Snakebite envenoming - treatment (Control of Neglected Tropical Diseases, who.int)

Verified against2 documents
  • WHO Snakebite envenoming - treatment (Control of Neglected Tropical Diseases, who.int)
  • Snake Bite - disease-level clinical article (snake-bite-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (1)

  • Nausea, vomiting, belly pain, lethargy, muscle weakness or twitching, and severe headache can mark systemic envenomation [abdominal pain · headache · lethargy · muscle weakness · nausea · vomiting]

Signs — what you find (7)

  • Fang marks at the bite site may or may not be visible on exam
  • Local tissue injury can show bruising, blistering, or outright necrosis [bruising · necrosis]
  • Neurotoxic envenomation starts with generalized weakness, drooping eyelids, and eye-movement paralysis, progressing to facial paralysis and respiratory failure [paralysis]
  • Active bleeding from the bite wound, nosebleeds, or spontaneous bleeding suggest a hemotoxic bite [bleeding · nosebleed]
  • Shock from venom can arise via vasodilation, low blood volume, or anaphylaxis [shock]
  • Elapid bites cause little local damage but a neurotoxic syndrome with systemic toxicity, pointing to that snake family
  • Viperid bites cause severe local tissue damage with a hemotoxic syndrome and systemic toxicity

Tests (6)

  • Suspected hemotoxin exposure calls for CBC, prothrombin time, partial thromboplastin time, and fibrinogen
  • Creatine kinase, electrolytes, and urinalysis screen for muscle breakdown and kidney involvement
  • Neurotoxicity is followed with end-tidal CO2 monitoring or serial arterial blood gases for evolving respiratory acidosis
  • Rapid venom testing can confirm a suspected snake species, but a negative result cannot rule one out
  • The bite site is watched closely for spreading swelling, blisters, or compartment syndrome
  • A direct compartment pressure over 30 mm Hg confirms early compartment syndrome

If not this — what else fits (5)

  • Without a witnessed snake bite, scorpion, tick, or spider bites are regional alternatives
  • Guillain-Barre syndrome is a consideration when the pattern is neurotoxic
  • Tick paralysis can mimic the same neurotoxic picture
  • Unexplained coagulopathy warrants work-up for a hereditary cause or an acquired disease such as DIC or ITP
  • Local tissue destruction can instead stem from trauma or a soft-tissue infection like cellulitis, abscess, or necrotizing fasciitis

SourceStatPearls "Evaluation and Treatment of Snake Envenomations" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (EMERGENCY REFERRAL)

1st line
Adult dose and duration

Immobilize the bitten limb (splint), keep patient completely still, and arrange immediate emergency transport to a hospital equipped with antivenom - Immediate emergency transfer

Paediatric dose

Immediate emergency pediatric transport

Dose source

WHO Snakebite envenoming - treatment (Control of Neglected Tropical Diseases, who.int)

Why

Primary care in Egypt rarely stocks appropriate polyvalent antivenom; immediate transfer is life-saving.

Cautions
  • DO NOT apply a tourniquet.
  • DO NOT incise, cut, or apply suction to the bite wound.
  • DO NOT apply ice or heat to the area.
  • Remove rings or constricting items before swelling occurs.
  • RED FLAG - Before hospital arrival, do NOT incise the wound, attempt oral or suction venom removal, apply ice, or give alcohol. Immobilize, keep the patient still, and transfer.
  • RED FLAG - Explicit warnings against dangerous lay first-aid practices (tourniquets, venom extractors, wound incision/washout) that increase morbidity are missing from the advice
  • RED FLAG - Signs of severe systemic toxicity, including profound neuromuscular blockade leading to diaphragmatic paralysis and respiratory insufficiency, are omitted

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.