How is the overall envenomation severity determined in snakebite?

Updated: Apr 09, 2021
  • Author: Spencer Greene, MD, MS, FACEP, FACMT, FAAEM; Chief Editor: Joe Alcock, MD, MS  more...
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The overall envenomation severity is determined by local and systemic findings and can be classified as follows:

  • Dry bites: These occur when there is no venom deposition, and therefore there are no signs or symptoms beyond a puncture wound. It is estimated that less than 10% of pit viper bites and 30-50% or coral snake bites are dry.

  • Minimal envenomations: These are characterized by local findings such as bruising, tenderness immediately adjacent to the bite site, and an absence of laboratory abnormalities and systemic findings.

  • Mild envenomations: These also lack laboratory abnormalities and systemic findings, but the local damage extends several centimeters from the bite site, all the way to a major joint (eg, ankle, wrist).

  • Moderate envenomations: These may be associated with non–life-threatening signs and symptoms (eg, vomiting, hematotoxicity without bleeding) and/or local damage that extends beyond two joints.

  • Severe envenomations: These result in extensive local damage (eg, beyond two joints) and/or significant systemic toxicity (eg, hypotension, airway swelling, muscle paralysis).

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