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Family: Viperidae
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Subfamily: Crotalinae
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Genus: Bothrops
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Species: lanceolatus
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Common Names
Martinique Lancehead , Fer-de-lance
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Local Names
Fer-de-lance , Le Serpent , Le Trigonocephale, Serpent , Vipere Jaune
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Region
South America
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Countries
Martinique
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Taxonomy and Biology
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Adult Length: 1.10 m
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General Shape
Large in length, relatively heavy bodied pitviper. Can grow to a maximum of over 2.00 metres ( a reported maximum 0f 2.98 metres ). Head is broad, flattened, lance shaped when viewed from above and distinct from narrow neck. Snout is not elevated. Eyes are medium in size with vertically elliptical pupils. Dorsal scales are strongly keeled.
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Habitat
Island contains tropical moist forest and tropical wet forest. Frequently found in rocky hill sides.
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Habits
Mainly a terrestrial and nocturnal snake with arboreal tendencies. Often climb into vines and some specimens have been found in vegetation as high as 20 metres or more above ground.
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Prey
Feeds mainly on rodents, birds an mongooses.
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Venom
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General: Venom Neurotoxins
Probably not present
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General: Venom Myotoxins
Probably not present
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General: Venom Procoagulants
Mixture of procoagulants
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General: Venom Anticoagulants
Not present
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General: Venom Haemorrhagins
Probably not present
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General: Venom Nephrotoxins
Probably not present
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General: Venom Cardiotoxins
Probably not present
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General: Venom Necrotoxins
Probably not present
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General: Venom Other
Unknown
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Clinical Effects
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General: Dangerousness
Severe envenoming possible, potentially lethal
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General: Rate of Envenoming: >80%
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General: Untreated Lethality Rate: 10-20%
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General: Local Effects
Local pain & swelling
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General: Local Necrosis
Does not occur, based on current clinical evidence
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General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, tachypnoea, respiratory distress, hypotension, dizziness, collapse or convulsions
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General: Neurotoxic Paralysis
Does not occur, based on current clinical evidence
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General: Myotoxicity
Does not occur, based on current clinical evidence
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General: Coagulopathy & Haemorrhages
Coagulopathy can occur in more severe cases, but major, even lethal thrombosis can occur, even in cases with otherwise limited local effects.
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General: Renal Damage
Insufficient clinical reports to know
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General: Cardiotoxicity
Does not occur, based on current clinical evidence
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General: Other
Shock secondary to fluid shifts due to local tissue injury is likely in severe cases
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First Aid
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Description: First aid for bites by Viperid snakes likely to cause significant local injury at the bite site (see listing in Comments section).
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Details
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. 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. The bitten limb should be immobilised as effectively as possible using an extemporised splint or sling; if available, crepe bandaging of the splinted limb is an effective form of immobilisation. 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.
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Treatment
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Treatment Summary
This treatment advice is general for most Bothrops species. Bites will vary from minor to life threatening. Therefore manage all bites as potentially major. Look for moderate to severe local effects, including pain, swelling, potential for fluid shifts and hypovolaemic shock, blistering, necrosis, abscess formation. Systemic effects may be minor or severe, possibly including coagulopathy and bleeding, kidney damage, even myolytic muscle damage. All cases with significant systemic effects require IV antivenom, as will most cases with significant local effects.
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Key Diagnostic Features
Local pain, swelling, thrombosis (DVT, pulmonary embolus, cerebral embolus) & secondary infarction (myocardial, cerebral, pulmonary)
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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.
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Antivenom Therapy
Antivenom is the key treatment for systemic envenoming. Multiple doses may be required. However, availability of specific antivenom is uncertain at present. The antivenoms listed on this site are those claimed by producers to cover all Bothrops species. Given the unique venom of Bothrops lanceolatus, it seems most uncertain that these claims are valid. However, in the absence of a specific antivenom for this species (the status of Pasteur Merieux F(ab)2 product is unknown to us as the producer has failed to respond to all communications) and knowing that only antivenom is effective, it would seem prudent to at least consider using one of the listed antivenoms, possibly the Venezuelan product. See clinical grading. All but most trivial cases need AV therapy.
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1. Antivenom Code: SAmICP01
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Antivenom Name: Polyvalent Antivenom
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Manufacturer: Instituto Clodomiro Picado
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Phone: ++506-2511-7888
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Address: Contiguo a la plaza de deportes, Dulce Nombre de Coronado. San José Costa Rica
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Country: Costa Rica
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2. Antivenom Code: SAmIBB03
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Antivenom Name: Soro antibotropico-laquetico
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Manufacturer: Instituto Butantan
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Phone: +55-11-3726-7222
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Address: Av. Vital Brasil, 1500 Butanta 05503-900 Sao Paulo - SP
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Country: Brazil
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3. Antivenom Code: SAmIBB05
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Antivenom Name: Soro botropico
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Manufacturer: Instituto Butantan
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Phone: +55-11-3726-7222
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Address: Av. Vital Brasil, 1500 Butanta 05503-900 Sao Paulo - SP
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Country: Brazil
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4. Antivenom Code: SAmFED01
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Antivenom Name: Soro Antibotropico
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Manufacturer: Fundacao Ezequiel Dias - FUNED
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Phone: ++55-31-3371-9525
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Address: Rua Conde Pereira Carneiro, 80 - Gameleria Belo Horizonte, MG - CEP 30510-010
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Country: Brazil
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5. Antivenom Code: SAmFED02
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Antivenom Name: Soro Anti-botropico-crotalico
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Manufacturer: Fundacao Ezequiel Dias - FUNED
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Phone: ++55-31-3371-9525
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Address: Rua Conde Pereira Carneiro, 80 - Gameleria Belo Horizonte, MG - CEP 30510-010
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Country: Brazil
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6. Antivenom Code: SAmFED04
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Antivenom Name: Soro Antibotropico-laquetico
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Manufacturer: Fundacao Ezequiel Dias - FUNED
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Phone: ++55-31-3371-9525
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Address: Rua Conde Pereira Carneiro, 80 - Gameleria Belo Horizonte, MG - CEP 30510-010
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Country: Brazil
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7. Antivenom Code: SAmIBB07
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Antivenom Name: Soro antibotropico-crotalico
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Manufacturer: Instituto Butantan
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Phone: +55-11-3726-7222
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Address: Av. Vital Brasil, 1500 Butanta 05503-900 Sao Paulo - SP
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Country: Brazil
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8. Antivenom Code: SAmIBM06
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Antivenom Name: Antivipmyn
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Manufacturer: Instituto Bioclon
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Phone: ++56-65-41-11
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Address: Calzada de Tlalpan No. 4687 Toriello Guerra C.P. 14050 Mexico, D.F.,
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Country: Mexico
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