[CCM-L] Monocled Cobra bite

[KMATTOX at aol.com]

Several of you asked and I dont remember if I told you.   The  local bite was 
on an index finger, occurring when he was changing the water  container in 
the snakes bin.      The local swelling is  minimal.  
 
k
 
 
 
 
 
In a message dated 6/30/2008 11:23:21 A.M. Central Daylight Time,  
prasannasimha at gmail.com writes:

Cobra  bites are primarily neurotoxic Naja - Neurotoxic while Krait and Viper 
are  hemotoxic.
Prasanna

On Mon, Jun 30, 2008 at 8:50 AM, <_KMATTOX at aol.com_ (mailto:KMATTOX at aol.com) 
> wrote:


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.     



 
____________________________________
 Gas prices getting you down? Search AOL Autos for fuel-efficient _used  
cars_ (http://autos.aol.com/used?ncid=aolaut00050000000007) .


_______________________________________________
Ccm-l  mailing list
_Ccm-l at lists.ccm-l.org_ (mailto:Ccm-l at lists.ccm-l.org) 
_http://lists.ccm-l.org/mailman/listinfo/ccm-l_ 
(http://lists.ccm-l.org/mailman/listinfo/ccm-l) 






-- 
Prasanna Simha M 




**************Gas prices getting you down? Search AOL Autos for 
fuel-efficient used cars.      (http://autos.aol.com/used?ncid=aolaut00050000000007)