Table 3. Clinical features on admission of victims of snakebite in southern Nepal between April 2010 and October 2012 (n=194).
Initial assessment of snakebite victims included vital signs, patients’ complaints and standardized evaluation of envenoming signs.
| Patient characteristics | Venomous species identified (n = 87) | Non-venomous species identified (n = 107) |
|---|---|---|
| Envenoming | ||
| Local signs | 4 (5.6%) | |
| Systemic signs | 38 (53.5%) | |
| Both | 29 (40.8%) | |
| None | 123 (63.4%) | |
| Level of consciousness | ||
| Alert | 84 (96.6%) | 107 (100%) |
| Responsive to voice | 2 (2.3%) | 0 |
| Responsive to pain | 1 (1.1%) | 0 |
| Unresponsive | 0 | 0 |
| Symptoms on admission (as reported by the patient) | ||
| Vomiting | 13 (14.9%) | 8 (7.5%) |
| Diarrhea | 3 (3.4%) | 1 (0.9%) |
| Difficulty in breathing | 4 (4.6%) | 0 |
| Pain | 60 (69%) | 16 (15%) |
| At the bite site | 37 (67.3%) | 15 (100%) |
| Abdominal pain | 11 (20%) | 1 (6.7%) |
| Double vision | 2 (2.3%) | 0 |
| Local signs on admission | ||
| Fang marks | 83 (95.4%) | 107 (100%) |
| Swelling | 41 (47.1%) | 2 (1.9%) |
| Local bleeding | 31 (35.6%) | 29 (27.1%) |
| Ecchymosis | 18 (20.7%) | 0 |
| Necrosis | 8 (9.2%) | 0 |
| Bullae | 1 (1.1%) | 0 |
| Palpable regional lymph node | 3 (8.8%) | 0 |
| Haemotoxic signs | ||
| Incoagulable blood | 7 (8%) | 0 |
| IV site bleeding | 0 | 1 (0.9%) |
| Neurotoxic signs and symptoms | ||
| Inability to frown | 9 (10.3%) | 0 |
| Bilateral ptosis | 54 (62.1%) | 0 |
| Inability to open mouth | 3 (3.4%) | 0 |
| Inability to protrude tongue | 5 (5.7%) | 0 |
| Inability to swallow | 26 (29.9%) | 0 |
| Muscle weakness | 0 | 0 |
| External ophthalmoplegia | 5 (5.7%) | 0 |
| Pupil not reacting to light | 18 (20.7%) | 7 (6.5%) |
| Speech difficulties | 0 | 0 |
| Broken neck sign | 0 | 0 |
| Loss of gag reflex | 0 | 0 |
Missing values are n = 1 (external ophthalmoplegia), n = 53 (palpable regional lymph nodes), n = 124 (pain location)