Here is a good paper on the types of snake bites you see in Sri Lanka
For Russell’s viper (
D. russelii) bites (319 cases), local swelling and regional lymphadenopathy developed in 307 (96%) patients. Incoagulable blood (20-minute whole blood clotting test) occurred in 244 (76%). There was persistent bleeding from bite (46%) or venipuncture (38%) sites. Spontaneous bleeding manifested as hematuria (47%), gum bleeding (34%), hematemesis (34%), vaginal or rectal bleeding (2%), and ecchymosis and bruising (11%). Acute renal failure that required peritoneal or hemodialysis developed in 60 (19%) patients. Fifty-seven percent showed neurotoxic signs, 24% showed generalized myalgia, and 2% showed respiratory failure that required mechanical ventilation.
For hump-nosed pit viper (
H. hypnale) (302 cases), 276 (91%) patients had local swelling and 186 (62%) had blistering. Incoagulable blood and spontaneous bleeding occurred in 117 patients (39%). Acute renal failure that required dialysis developed in 30 (10%) patients. None had neurotoxic signs.
For saw-scaled viper (
E. carinatus) (1 case), local bleeding, swelling, incoagulable blood, and spontaneous bleeding developed in one patient. He did not develop acute renal failure or neurotoxicity.
For cobra (
N. naja) (45 cases), these patients often had severe neurotoxic signs and/or local envenoming (swelling, pain, blistering, necrosis). Local swelling developed in 91% of patients, blistering in 84%, and necrosis in 67%. Thirty-four patients (76%) required wound debridement and 16 (36%) needed skin grafting. Eight (18%) required amputation of limbs, fingers, or toes. Thirty-six (80%) developed neurotoxic signs, of which 35 (78%) had ptosis, 29 (64%) had ophthalmoplegia, 6 (13%) had dysphagia, and 9% had respiratory failure that required mechanical ventilation. No patient developed spontaneous bleeding, incoagulable blood, or acute renal failure.
For common krait (
B. caeruleus) (88 cases), symptoms or signs of local envenoming (minimal swelling, pain, paraesthesiae) were recorded in 9% of the patients. Typical neurotoxic signs, such as partial or complete ptosis, external ophthalmoplegia, and difficulty in breathing, which were identical to those observed in cobra bite victims, developed in 84 (95%) patients and respiratory failure that required mechanical ventilation developed in 64%. Abdominal pain and/or vomiting were reported in 80 (91%). No patient had spontaneous bleeding or incoagulable blood.
For sea snake (
Hydrophis spiralis) (1 case), one bite victim had no signs of local envenoming. Multiple fang marks were observed at the site of bite. He had severe myalgia, muscle tenderness, and neurotoxic signs but did not develop respiratory failure or acute renal failure.
For green pit viper (
Trimeresurus trigonocephalus) (6 cases), four patients (67%) had local swelling. One complained of abdominal pain and vomiting. None had signs of systemic envenoming.
Syndromic Approach to Treatment of Snake Bite in Sri Lanka Based on Results of a Prospective National Hospital-Based Survey of Patients Envenomed by Identified Snakes
And the scariest thing of that article is that antivenom was used...Like I said it is not the lack of antivenom supplies that is the problem...It is the delay in getting the antivenom and the fact that it does not reverse damage already caused by the venom...and then it also appears to be rather ineffective in dealing with krait bites. Had you just given antivenom to common krait patients....56 of the 88 patients would have died...Luckily ventillators are available in Sri Lanka
"Antivenom was used in 77% of bites by Russell’s viper, 78% of bites by cobras, 95% of bites by the common krait, 19% of bites by hump-nosed vipers, and all bites by green pit vipers."
Syndromic Approach to Treatment of Snake Bite in Sri Lanka Based on Results of a Prospective National Hospital-Based Survey of Patients Envenomed by Identified Snakes
