Monocled Cobra bite

[Rangraj Setlur]

<snip> I am not specifically aware of any issues other than these with the
monocled cobra (what is its species name?)*
*Its the archetypal elapid. Species naja, genus naja.From sanskrit nag
meaning snake. We were taught that cobras would avoid biting unless
cornered, unlike kraits which would sometimes bite without provocation.I
have no idea if thats true.
rangraj
from wiki
*Naja naja* is a species of
venomous<http://en.wikipedia.org/wiki/Venomous_snake>
snake <http://en.wikipedia.org/wiki/Snake> native to the Indian
subcontinent. It is the most famous of the *Big Four*, the four most
venomous snakes of India for which a single polyvalent antivenin has been
created. Like other cobras, *N. naja* is famous for its threat display
involving raising the front part of its body and spreading its hood. This
snake is revered in Indian mythology and culture and is often seen with
snake-charmers. It is now protected in India under the Indian Wildlife
Protection Act (1972).The Indian cobra's celebrity comes from its popularity
as a snake of choice for snake charmers. The cobra's dramatic threat posture
makes for a unique spectacle as it appears to sway to the tune of a snake
charmer's flute. Snake charmers with their cobras in a wicker basket are a
common sight in many parts of India only during the Nag Panchami festival.
The cobra, of course, is deaf to the snake charmer's pipe, but follows the
visual cue of the moving pipe and it can sense the ground vibrations from
the snake charmer's tapping foot.

On Mon, Jun 30, 2008 at 11:45 AM, Timothy Craig Hardcastle <
TimothyHar at ialch.co.za> wrote:

> Ken
>
> Cobras are genus Naja. They are almost exclusively neurotoxic and can
> cause death from respiratory arrest within 45 - 120 minutes post bite.
> They are endemic in South Africa and we see their bites with some
> frequency.
>
> In South Africa a polyvalent antivenin for Cobra, Mamba (Dendroaspis)
> and puff adder bites (Bitis) is available and the recommended dose is 80
> - 120 ml IVI as soon as possible. You may repeat the dose once, being
> prepared for allergic reaction.
>
> Remember the patient is usually paralysed, but conscious, so sedatrion
> is required.
>
> Slow recovery over several weeks is the usual course of the pathology
> when an adult snake is the assailant, but can be less severe with
> juveniles. Extensive early physical therapy is advised.
>
> I am not specifically aware of any issues other than these with the
> monocled cobra (what is its species name?)
>
> Hope this helps.
>
> Attached is a recent article with a syndromic approach to snake bites.
>
> Tim
> Dr Timothy C Hardcastle
> M.B., Ch.B. (Stell); M. Med (Chir) (Stell); FCS (SA)
> Principal Surgeon-Lecturer / Sub-specialist: Trauma and Critical Care
> Deputy director: Trauma Unit and Trauma ICU
> Inkosi Albert Luthuli Central Hospital / UKZN
> 800 Bellair Road
> Mayville, Durban
>
> Postal: PostNet Suite 27
> Private Bag X05
> Malvern, 4055
> KwaZulu Natal
>
> timothyhar at ialch.co.za
>
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of KMATTOX at aol.com
> Sent: 30 June 2008 05:20
> To: trauma-list at trauma.org
> Cc: SURGINET at listserv.utoronto.ca; ccm-l at ccm-l.org
> Subject: Monocled Cobra bite
>
> For the endemic and usual kinds of poisonous snake bites in the United
> States I have always proposed to be very sparingly in using  antivenin.
> Today we
> received a patient arriving less than 40  minutes after being bitten on
> the
> finger by a monocled cobra.     He breeds and raises these snakes and
> his
> business is known to the authorities  and the game warden near his
> house.
>
> Shortly after arrival his respiration just stopped and he was
> intubated.
> He was sedated as if he had been given a muscle  relaxant.   His
> BP,clotting
> studies were basically normal.    His TEG was normal.     He required no
>
> pressors.    He had basically NO swelling or discoloration  at the site
> of the bite
> as we usually see in US poisonous  snakes.     We called around the
> country
> and the  consensus was that he should receive specific antivenin.    The
>
> closest antivenin was 1/4 the way across Texas (None in Houston or
> Galveston),  so
> it was flown here and he has received 6 vials of Naja specific
> antivenin.
> He is in the ICU and being supported with the  usual ICU care.
>
>
> The reason I am posting this is for several reasons:
>
> 1.    Cobra bites are RARE in the United States
> 2.    I find that cobra breeders and sellers are fairly  common in the
> United
> States
> 3.    I found that the NEUROLOGIC paralysis was rapid  and sure, and the
>
> hematological and coagulopathies effects of the antivenin  were not
> seen.
> 4.    Several of you on this web site have seen cobra  bites.
>
> I am seeking wisdom and advice as well as long range outcomes  and
> effects.
>   I feel certain that we will  receive a large variety of opinion and
> advice.   We will receive and  welcome any and all and will weigh all
> advice against
> his clinical  course.
>
> Thanks in advance.
>
>
>
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-- 
Lt Col Rangraj Setlur
Associate Professor
Department of Anaesthesiology and Critical Care
Armed Forces Medical College
Pune
India