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Hemachatus haemachatus
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Family: Elapidae
Subfamily: Elapinae
Genus: Hemachatus
Species: haemachatus
Common Names
Rinkals , Ringhals , Ring-necked Spitting Cobra
Sub-Saharan Africa
Lesotho, South Africa, Swaziland, Zimbabwe
Taxonomy and Biology
Adult Length: 1.00 m
General Shape
Medium in length, slightly compressed, tapering and moderately slender bodied snake ( but relatively thick set when compared to other cobras ) with a short tail. Can grow to a maximum of about 1.50 metres. Neck region capable of expansion into a hood. Head is relatively broad, flattened, with a distinct canthus and indistinct from neck. Snout is obtusely pointed. Eyes are medium in size with round pupils. Dorsal scales are strongly keeled. Dorsal scale count usually ( 17 or 19 ) - 19 - 13. A spitting cobra.
Coastal grassland to highveld grassland up to about 2500 metres.
Nocturnal. If threatened, it will rear up and spread its hood. Capable of spitting venom up to 2 or 3 metres toward the eyes of an aggressor, but if it misses will feign death by rolling onto its back and remain motionless with the mouth agape.
Prefers rodents but will feed on most small vertebrates, particularly toads.
Species Map
Small (Approx 20k) version
Average Venom Qty
80 to 120 mg ( dry weight ), Minton (1974) ( Ref : R000504 ).
General: Venom Neurotoxins
Possibly present
General: Venom Myotoxins
Probably not present
General: Venom Procoagulants
Probably not present
General: Venom Anticoagulants
Probably not present
General: Venom Haemorrhagins
Possibly present
General: Venom Nephrotoxins
Probably not present
General: Venom Cardiotoxins
Present but not defined
General: Venom Necrotoxins
Possibly present
General: Venom Other
Clinical Effects
General: Dangerousness
Severe envenoming possible, potentially lethal
General: Rate of Envenoming: Unknown but likely to be high
General: Untreated Lethality Rate: Unknown but lethal potential cannot be excluded
General: Local Effects
Local pain & swelling
General: Local Necrosis
Not likely to occur
General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, dizziness, collapse or convulsions
General: Neurotoxic Paralysis
Only minor neurotoxicity reported
General: Myotoxicity
Does not occur, based on current clinical evidence
General: Coagulopathy & Haemorrhages
Does not occur, based on current clinical evidence
General: Renal Damage
Does not occur, based on current clinical evidence
General: Cardiotoxicity
Insufficient clinical reports to know
General: Other
First Aid
Description: First aid for bites by Elapid snakes which do not generally cause significant injury at the bite site (see Comments for partial listing), though have the potential to cause injury by spitting venom, but which may have the potential to cause significant general (systemic) effects, such as paralysis, muscle damage, or bleeding.
Section 1: General first aid (for first aid for venom spit ophthalmia see Section 2 below).
1. After ensuring the patient and onlookers have moved out of range of further strikes by the snake, the bitten person should be reassured and persuaded to lie down and remain still. Many will be terrified, fearing sudden death and, in this mood, they may behave irrationally or even hysterically. The basis for reassurance is the fact that many venomous bites do not result in envenoming, the relatively slow progression to severe envenoming (hours following elapid bites, days following viper bites) and the effectiveness of modern medical treatment.
2. The bite wound should not be tampered with in any way. Wiping it once with a damp cloth to remove surface venom is unlikely to do much harm (or good) but the wound must not be massaged. For Australian snakes only, do not wash or clean the wound in any way, as this may interfere with later venom detection once in a hospital.
3. All rings or other jewellery on the bitten limb, especially on fingers, should be removed, as they may act as tourniquets if oedema develops.
4. If the bite is on a limb, a broad bandage (even torn strips of clothing or pantyhose) should be applied over the bitten area at moderate pressure (as for a sprain; not so tight circulation is impaired), then extended to cover as much of the bitten limb as possible, including fingers or toes, going over the top of clothing rather than risking excessive limb movement by removing clothing. The bitten limb should then be immobilised as effectively as possible using an extemporised splint or sling.
5. If there is any impairment of vital functions, such as problems with respiration, airway, circulation, heart function, these must be supported as a priority. In particular, for bites causing flaccid paralysis, including respiratory paralysis, both airway and respiration may be impaired, requiring urgent and prolonged treatment, which may include the mouth to mask (mouth to mouth) technique of expired air transfer. Seek urgent medical attention.
6. Do not use Tourniquets, cut, suck or scarify the wound or apply chemicals or electric shock.
7. Avoid peroral intake, absolutely no alcohol. No sedatives outside hospital. If there will be considerable delay before reaching medical aid, measured in several hours to days, then give clear fluids by mouth to prevent dehydration.
8. If the offending snake has been killed it should be brought with the patient for identification (only relevant in areas where there are more than one naturally occurring venomous snake species), but be careful to avoid touching the head, as even a dead snake can envenom. No attempt should be made to pursue the snake into the undergrowth as this will risk further bites.
9. The snakebite victim should be transported as quickly and as passively as possible to the nearest place where they can be seen by a medically-trained person (health station, dispensary, clinic or hospital). The bitten limb must not be exercised as muscular contraction will promote systemic absorption of venom. If no motor vehicle or boat is available, the patient can be carried on a stretcher or hurdle, on the pillion or crossbar of a bicycle or on someone's back.
10. Most traditional, and many of the more recently fashionable, first aid measures are useless and potentially dangerous. These include local cauterization, incision, excision, amputation, suction by mouth, vacuum pump or syringe, combined incision and suction ("venom-ex" apparatus), injection or instillation of compounds such as potassium permanganate, phenol (carbolic soap) and trypsin, application of electric shocks or ice (cryotherapy), use of traditional herbal, folk and other remedies including the ingestion of emetic plant products and parts of the snake, multiple incisions, tattooing and so on.

Section 2: First aid for venom spit ophthalmia.
1. Venom coming into contact with eyes can cause intense conjunctivitis with a risk of corneal erosions, complicated by secondary infection, anterior uveitis and even permanent blindness. All this can occur following venom spat into the eyes from a spitting cobra.
2. Irrigate the eye or other affected mucous membrane as soon as possible using large volumes of water or any other available bland fluid. Never use chemical solutions or petroleum products such as petrol or kerosene. Milk is soothing and can be used, or in an emergency beer or urine are possibilities. Keep irrigating the eyes, hold them under a slowly running tap for a several minutes, while opening the eyelids and rotating the eyeball. The eye will be very painful, so patience, tact and reassurance are needed.
3. The eye should be bandaged using a pad over the eye and dark glasses worn.
4. Don't let the victim rub the eye.
5. Seek urgent medical attention.
Treatment Summary
Bites by these snakes can cause moderate to severe envenoming, with some local effects, but not necrosis, & systemic effects, including flaccid paralysis. All cases should be admitted. Systemic envenoming usually requires antivenom therapy. If respiratory paralysis, intubate & ventilate.
Key Diagnostic Features
Local pain, swelling, ± flaccid paralysis
General Approach to Management
All cases should be treated as urgent & potentially lethal. Rapid assessment & commencement of treatment including appropriate antivenom (if indicated & available) is mandatory. Admit all cases.
Antivenom Therapy
Antivenom is the key treatment for systemic envenoming. Multiple doses may be required.
1. Antivenom Code: SAfSAI03
Antivenom Name: SAIMR Polyvalent Antivenom
Manufacturer: South African Vaccine Producers (Pty) Ltd
Phone: +27 11 386-6000; +27 11 386-6078
Address: Postal address
PO Box 28999
Sandringham 2131
Gauteng Province

Physical address
1 Modderfontein Road
Sandringham, Johannesburg
Country: South Africa
2. Antivenom Code: SAfSAIBK
Antivenom Name: SAIMR Snakebite Kit
Manufacturer: South African Vaccine Producers (Pty) Ltd
Phone: +27 11 386-6000; +27 11 386-6078
Address: Postal address
PO Box 28999
Sandringham 2131
Gauteng Province

Physical address
1 Modderfontein Road
Sandringham, Johannesburg
Country: South Africa
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