Snake Bite

Aka: Snake Bite, SnakeBite, Rattlesnake, Copperhead, Cottonmouth, Coral Snake, Snake Venom, Snake Envenomation, Crotalid Venom, Pit Viper Venom, Elapid Venom

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II. Epidemiology

  1. U.S. Incidence
    1. Total: 45,000 Snake Bites in U.S. per year
    2. Venomous bites: 8000 to 9000 in U.S. per year (almost all are Pit Viper bites)
    3. Deaths from Snake Bite in U.S.: 12 or less per year
    4. Envonomation occurs in 75% of U.S. poisonous SnakeBites
  2. Worldwide Snake Bites (esp. Africa, Asia, Latin America)
    1. Incidence: 1.8 to 2.7 Million Snake Bites/year worldwide (50% are venomous)
    2. Roughly 81,000 to 138,000 deaths per year worldwide from Snake Bites
    3. Roughly 300,000 amputations per year worldwide from Snake Bites

III. Causes: U.S. Poisonous snakes

  1. Pit Vipers or Crotalidae (99% U.S. venomous bites)
    1. Characteristics
      1. Broad, triangle-shaped head with elliptical pupils and heat sensing loreal pits
      2. Fangs are long and retractable
    2. Rattlesnake (Crotalus or Sisturus genera)
      1. Most common poisonous snake in U.S.
      2. Potent venom
      3. Responsible for 95% of deaths (esp. Diamondback)
    3. Cottonmouth, water moccasin (Agkistrodon piscivorous)
      1. Aggressive water snakes in Southeastern U.S.
      2. Moderately potent venom
    4. Copperhead (Agkistrodan contortix)
      1. Least potent venom
  2. Coral Snakes (Family Elapidae)
    1. Characteristics
      1. Round heads with round pupils, and smooth scales
      2. Fangs are short and fixed
        1. Transfer venom via chewing instead of injection
    2. Nonaggressive poisonous Coral Snakes of the southern U.S.
      1. Arizona Sonoran Coral Snake (Micruroides Euryxanthus)
      2. Texas Coral Snake (Micrurus Tener)
        1. Neurotoxic effects may present with findings similar to Botulism
      3. Eastern Coral Snake (Micrurus Fulvius)
        1. Primarily in the southeast United States (Mississippi and Alabama south to Florida)
    3. Worldwide, Elapidae are among the most dangerous, infamous poisonous snakes
      1. Cobras
      2. Kraits
      3. Sea snakes
      4. Mambas

IV. History

  1. Snake appearance (photo if available) and suspected variety or species
  2. Time elapsed since Snake Bite
  3. Symptoms and their timing since the Snake Bite occurred
  4. Last tetanus Vaccination

V. Signs and Symptoms: Pit Vipers (except Mojave rattler)

  1. Snake characteristics
    1. Long movable fangs cause skin puncture marks
    2. Broad triangular heads with elliptical eyes and heat sensing pits between the eyes and nostrils
    3. Bites may be deceptively small or appear as scratches and still result in severe Envenomations
    4. Up to 25% of pit viper bites deliver no venom (dry bites)
      1. All bites should be presumed venomous initially (delays increase morbidity and mortality)
  2. Local Tissue Necrosis
    1. Mechanism: Venom alters Coagulation Factors (via Thrombin-like Glycoproteins) resulting in consumptive Coagulopathy
    2. Immediate pain and burning at bite site
    3. Within a few minutes to 30 minutes, redness and swelling develops (may extend to include entire extremity)
    4. Bite site develops a purplish discoloration, hemorrhagic bullae and necrosis within hours
  3. Generalized signs and symptoms (Hemotoxic effects)
    1. Nausea and Vomiting
    2. Dizziness and Hypotension
    3. Weakness
    4. Sweats and chills
    5. Metallic or Rubbery taste in mouth
  4. Generalized neurotoxic effects (only with U.S. West Coast Rattlesnakes: Mojave, tiger and some timber Rattlesnakes)
    1. Muscle Fasciculations
  5. Systemic complications
    1. Disseminated Intravascular Coagulation (DIC)
    2. Acute Renal Failure
    3. Hypovolemic Shock (7% of cases)
    4. Rhabdomyolysis (if muscle Fasciculations)
    5. Compartment Syndrome (rare)
  6. Course
    1. Not immediately fatal unless Envenomation into vein

VI. Signs and Symptoms: Coral Snakes (Elapidae)

  1. Characteristics
    1. Small fixed fangs cause tiny semicircular scratches
    2. Bites are painful
    3. Venom contains a Neurotoxin (primarily affecting Acetylcholine receptors)
      1. Results in paralysis
      2. Contrast with the pit viper related local tissue injury and cogualopathy
    4. Coral Snake: Red stripe next to yellow stripe ("Red next to yellow, you're a dead fellow")
      1. Contrast with King Snake
        1. Red stripe next to black stripe ("Red next to black, venom they lack")
      2. This rule applies only in the U.S.
        1. Outside the U.S., Red and Black snakes may be venomous
  2. Generalized symptoms may be delayed 1-8 hours (local effects may have onset in first 15 min)
    1. Drowsiness, Weakness
    2. Paresthesias with numbness at bite site
    3. Bulbar Paralysis with Ptosis, Ophthalmoplegia or Dysphagia
    4. Blurred Vision
    5. Slurred speech
    6. Salivation
    7. Seizures
  3. Systemic complications (develop over time after initial visual effects)
    1. Descending Flaccid Paralysis
    2. Cardiac Arrest or respiratory arrest may occur

VII. Labs

  1. Blood Type and Cross Match
  2. Urinalysis
  3. Chemistry panel (e.g. Chem8)
    1. Renal Function tests (BUN and Creatinine)
    2. Serum Electrolytes
    3. Serum Glucose
  4. Complete Blood Count with Platelet Count
    1. Thrombocytopenia occurs with pit viper bites
      1. May be delayed (repeat Platelet Count in 7-10 days)
  5. Liver Function Tests
  6. Creatine Kinase (CK)
    1. May be increased in Pit Viper Bites (esp. with Timber Rattlesnake)
  7. Coagulation Factors (draw baseline and at 12 hours)
    1. Prothrombin Time (PT/INR)
      1. May be increased in Pit Viper Bites
    2. Partial Thromboplastin Time (PTT)
    3. Fibrinogen
      1. May be decreased in Pit Viper Bites
    4. Fibrin Split Products
    5. D-Dimer
      1. May be increased in Pit Viper Bites
    6. Creatine Phosphokinase (CPK)
  8. Other studies that may be indicated (esp. Coral Snake bites)
    1. Arterial Blood Gas (ABG)
    2. Waveform Capnography
    3. Pulmonary Function Tests
    4. Troponin I

VIII. Differential Diagnosis

  1. Anaphylaxis
    1. Presents with Hypotension, Tachycardia and Angioedema (similar to severe Envenomation)

IX. Diagnostics

  1. Electrocardiogram (EKG)

X. Management: First Aid in Field

  1. Get to a medical facility equipped with antivenom as soon as possible (ideally by EMS)
    1. Decompensation may occur rapidly
  2. Calm and reassure patient
  3. Attempt to identify snake type from a distance (photo, color and pattern description)
    1. Do not try to capture the snake for Identification
    2. Do not attempt to handle even a dead snake (Envenomations occur from intact bite reflex)
    3. Adult snake versus baby snake is unlikely to change management (both can cause severe Envenomations)
  4. Do not leave a patient alone
  5. Have the patient lie down
  6. Immobilize bite area
    1. Rattlesnake: Level with the heart
    2. Non-Rattlesnake Pit Viper: Above the level of the heart (may reduce local tissue swelling and inflammation)
    3. Coral Snake: Below the level of the heart (may reduce systemic toxin distribution)
  7. Remove jewelry or clothing that tighten with swelling
  8. Clean the bite area with soap and water
    1. Irrigate the wound with clean water or saline
    2. Apply antiseptic solution and gauze if available
  9. Mechanical venom suction devices are NOT recommended (only remove 2% of venom)
    1. Previously small vacuum venom extractor devices were recommended
      1. Had previously been indicated within 5 minutes of bite, left in place for 30 min
    2. Do not cut wound or try to suck out venom
    3. Avoid harmful methods (see below) at bite site
  10. Low pressure constriction band (NOT a Tourniquet!)
    1. Indicated if medical assistance is >1 hour away and neurotoxic effects are expected
      1. Primarily indicated for Coral Snake bites (not pit vipers)
      2. Australians apply Crepe Wrapping (ACE Wrap from distal to proximal extremity) to impede lymph flow
        1. Theoretically prevents Neurotoxin proximal spread and paralysis
        2. NOT indicated in United States (where we do not have the same neurotoxic snakes)
    2. Wrap A band (ACE, belt, sock) 2-3 inches above bite
      1. Band should be wide and flat
      2. Band applied between bite site and heart
    3. Do not cut off arterial circulation (again, NOT a Tourniquet)
      1. Pressure: 20 mmHg
      2. Be able to slip a finger between band and skin
    4. Leave band in place until medical facility
    5. Contraindications to low pressure constriction band
      1. Gila Monster
      2. Copperhead
      3. Water moccasin
      4. Pygmy Rattlesnake

XI. Management: Emergency Department

  1. Contact poison control immediately (in U.S., 1-800-222-1222)
    1. Local zoo herpetologist may also be helpful in snake identification
  2. ABC Management
    1. Angioedema may occur requiring airway management
    2. Do not draw blood or start IV in affected extremity
    3. Start Intravenous Fluids
    4. Manage Hypotension (IV fluids, Vasopressors)
    5. Consider Epinephrine and Corticosteroids if signs of Anaphylaxis
  3. Bite Wound Management
    1. Clean and irrigate the wound
    2. Tetanus Toxoid
    3. Opioid Analgesics are often needed (esp. pit viper bites)
    4. Elevate extremity >60 degrees (reduces pain by decreasing localized swelling)
    5. Even wounds that appear deceptively small or scratch-like may result in severe Envenomation
    6. Prophylactic Antibiotics are not recommended (<5% infection risk)
  4. Antivenom
    1. See Snake Antivenin
    2. Administer antivenom as soon as possible
      1. However there is not a fixed time window at which point it is too late to give to a symptomatic patient
    3. Indications (even for seemingly mild pit viper bites)
      1. Any signs of systemic Envenomation (e.g. Nausea, Vomiting)
      2. Hypotension or cardiovascular toxicity
      3. Neurotoxicity or myotoxicity (coral Snake Envenomation)
      4. Lab abnormalities (e.g. Thrombocytopenia, low Fibrinogen, increased INR)
      5. Progressive and significant erythema, swelling or pain
      6. Spontaneous systemic bleeding or Coagulopathy
      7. Bites involving the hand or foot (esp. fingers or toes)
    4. Monitor labs at baseline (see above), one hour after antivenom, and then every 6 hours until stable
    5. Monitor for Anaphylaxis and anaphylactoid reactions
    6. Recheck at 48 to 72 hours for repeat CBC, Fibrinogen (for hematologic toxicity)
  5. Suspected pit viper bite management (local swelling and inflammation)
    1. Observe asymptomatic patients 8-12 hours after bite
      1. One quarter of bites are "dry" without venom injected
    2. Monitor frequent pulse checks (every 30 minutes) at a point distal to the bite site
      1. Pulse check with Capillary Refill
      2. Circumferential measurement around extremity bite wounds
    3. Mark leading edge of bite site swelling and erythema every 30 minutes
    4. Hospital admission for any patient who received antivenom
      1. May discharge if stable swelling and labs for 24 hours
    5. Indications for discharge
      1. No proximal spread of extremity findings
      2. Normal laboratory studies
      3. Patient able to return immediately for worsening
      4. Patient should return for Coagulopathy signs or pain not relieved with limb elevation
  6. Suspected Coral Snake bite management
    1. Observe asymptomatic patient for at least 12-24 hours
    2. Monitor neurologic status and respiratory status closely
    3. Requires immediate treatment and antivenin
    4. Neurologic complications may be delayed
    5. Consider Anticholinergics (Atropine, neostigmine)
    6. Hospital admission for any patient who received antivenom
    7. Intubation and Ventilator support may be required
      1. Indicated for Forced Vital Capacity <50% of predicted

XII. Precautions: Avoid harmful methods

  1. Do not cut skin at bite site
  2. Fasciotomy is rarely indicated
    1. Compartment Syndrome may be controlled by antivenin
    2. Only Consider if hourly serial ICP >30 mmHg
  3. Do not use electric shock or stun gun at bite site
  4. Do not apply tightly constricting Tourniquet
  5. Do not administer antivenin in the field
    1. Risk of Anaphylaxis
  6. Delayed Thrombocytopenia (antivenin-refractory) may occur
    1. Recheck Platelet Count again in 7-10 days

XIII. Prevention

  1. On coming upon a snake:
    1. Slowly and quietly move away, and allow it to escape
    2. Do not expect a warning before they strike
      1. Most snakes do not hiss or rattle before striking
    3. Do not handle any snake (even if snake appears dead)
  2. Be alert in areas commonly inhabited by snakes
    1. Hiking, picnicking, camping and firewood areas
    2. Water areas
    3. Tall grass, underbrush, abandoned buildings
    4. Piles of logs, rocks, and branches
  3. Be careful of areas of decreased visibility
    1. Avoid reaching into holes and crevices
    2. Avoid jumping over logs and fences
    3. Pull logs or rocks toward you when turning over
    4. Avoid placing fingers under objects being lifted
  4. Prepare for a hike
    1. Wear boots and long pants
    2. Carry a flashlight for nighttime conditions
    3. Hike with a companion
  5. Reduce residential risks of Snake Bite
    1. Provide lighting for yard, sidewalks, and patio
    2. Keep yard mowed and bushes pruned
    3. Keep home free of mice

XIV. References

  1. Cowling and Ferreri (2019) Crit Dec Emerg Med 33(2): 17-25
  2. Cowling and Lowes (2024) Crit Dec Emerg Med 38(1): 4-13
  3. Mason and Brandehoff (2020) EM:Rap 20(9): 13-4
  4. (1998) Postgrad Med 103(4): 311 [PubMed]
  5. Juckett (2002) Am Fam Physician 65(7):1367-74 [PubMed]
  6. Lavonas (2011) BMC Emerg Med 11:2 +PMID: 21291549 [PubMed]
  7. McKinney (2001) Ann Emerg Med 37(2):168-74 [PubMed]

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Related Studies

Ontology: Crotalid Venoms (C0010369)

Definition (MSH) Venoms from snakes of the subfamily Crotalinae or pit vipers, found mostly in the Americas. They include the rattlesnake, cottonmouth, fer-de-lance, bushmaster, and American copperhead. Their venoms contain nontoxic proteins, cardio-, hemo-, cyto-, and neurotoxins, and many enzymes, especially phospholipases A. Many of the toxins have been characterized.
Concepts Biologically Active Substance (T123) , Hazardous or Poisonous Substance (T131)
MSH D003435
English Crotalid Venoms, Pit Viper Venoms, Venoms, Crotalid, Venoms, Pit Viper, Crotalid Venom, Venom, Crotalid, Pit Viper Venom, Venom, Pit Viper, Viper Venom, Pit, Crotalid Venoms [Chemical/Ingredient]
Swedish Skallerormsgifter
Czech chřestýší jedy
Finnish Kalkkarokäärmemyrkyt
Russian PRESMYKAIUSHCHIKHSIA IADY, ZMEIA GREMUCHAIA, IADY, ZMEI IAMKOGOLOVYE, IADY, IADY ZMEI IAMKOGOLOVYKH, ЗМЕИ ЯМКОГОЛОВЫЕ, ЯДЫ, ЗМЕЯ ГРЕМУЧАЯ, ЯДЫ, ПРЕСМЫКАЮЩИХСЯ ЯДЫ, ЯДЫ ЗМЕЙ ЯМКОГОЛОВЫХ
Japanese ハブ毒, ガラガラヘビ毒, ガラガラヘビ科毒
French Venins de crotalidé
Italian Veleni dei Crotalidae, Veleno dei Crotalidae
Polish Jady grzechotnika
Spanish Veneno de Crotálido, Venenos de Crotálido, Venenos de Crótalos, Venenos de Crotálidos, Venenos de Víbora Hoyo
Portuguese Venenos de Crotalídeo, Veneno de Crotalídeo, Venenos de Crotalídeos
German Crotalidgifte, Grubenottergifte
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Elapid Venoms (C0013757)

Definition (MSH) Venoms from snakes of the family Elapidae, including cobras, kraits, mambas, coral, tiger, and Australian snakes. The venoms contain polypeptide toxins of various kinds, cytolytic, hemolytic, and neurotoxic factors, but fewer enzymes than viper or crotalid venoms. Many of the toxins have been characterized.
Concepts Biologically Active Substance (T123) , Hazardous or Poisonous Substance (T131)
MSH D004546
SnomedCT 303306002
English Elapid Venoms, Venoms, Elapid, Elapid Venom, Venom, Elapid, Elapid Venoms [Chemical/Ingredient], Elapid venom, Elapid venom (substance)
Swedish Elapidgifter
Czech Elapidae - jedy
Finnish Myrkkytarhakäärmemyrkyt
Russian IADY ASPIDOVYKH ZMEI, IADY MORSKIKH ZMEI, ЯДЫ МОРСКИХ ЗМЕЙ, ЯДЫ АСПИДОВЫХ ЗМЕЙ
Italian Veleno degli elapidi, Veleni degli elapidi
Polish Jady zdradnicowatych
Japanese メガネヘビ毒, メガネヘビ科毒, メガネ蛇毒
French Venins des élapidés
Spanish Venenos Elapídicos, veneno de víbora coral (sustancia), veneno de víbora coral
German Natterngifte
Portuguese Venenos Elapídicos
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Snake Bites (C0037379)

Definition (MSH) Bites by snakes. Bite by a venomous snake is characterized by stinging pain at the wound puncture. The venom injected at the site of the bite is capable of producing a deleterious effect on the blood or on the nervous system. (Webster's 3d ed; from Dorland, 27th ed, at snake, venomous)
Concepts Injury or Poisoning (T037)
MSH D012909
ICD10 T63.0
SnomedCT 83527007, 269782003, 61288004
English Snake Bite, Snake Envenomation, Envenomation, Snake, Envenomations, Snake, Snake Envenomations, Bite, Snake, Bites, Snake, Snake venom, Snake venom - toxic effect, Toxic effect of snake venom, Snake Bites, Snakebites, Snakebite, Snake Bites [Disease/Finding], Adverse effect;venom;snake, snake bites, snake envenomations, snake bite, Toxic effect of bite of venomous snake (disorder), Snake venom poison, Snake envenomation, Snake venom causing toxic effect, Poisoning by venomous snake (disorder), Poisoning by venomous snake, Snake bite poisoning, Snake venom poisoning, Toxic effect of bite of venomous snake, snake bite poison, bite; poisoning, snake, Poisoning by venomous snake, NOS, Snake bite poisoning, NOS, Snake venom poisoning, NOS, Toxic effect of bite of venomous snake, NOS, Toxic effect of bite of venomous snake -RETIRED-, snake envenomation
Swedish Ormbett
Czech hadi - uštknutí
Finnish Käärmeenpuremat
Russian ZMEINYE UKUSY, UKUSY ZMEI, УКУСЫ ЗМЕИ, ЗМЕИНЫЕ УКУСЫ
German Toxische Wirkung: Schlangengift, Schlangenbisse, Schlangenvergiftung
Korean 뱀독의 중독작용
Croatian ZMIJSKI UJED
Polish Ukąszenie przez węża
Japanese ヘビ咬傷, だ咬症, ヘビ中毒症, 毒蛇咬症, 蛇咬傷(ダコウショウ), 蛇咬症, 蛇中毒症, 蛇咬傷
Norwegian Ormebitt, Slangebitt
Spanish Mordeduras de Serpientes, efecto tóxico de la mordedura de serpiente venenosa - RETIRADO -, efecto tóxico de la mordedura de serpiente venenosa - RETIRADO - (concepto no activo), Mordedura de Serpiente, Mordeduras de Serpiente, envenenamiento por mordedura de serpiente, envenenamiento por serpiente venenosa (trastorno), envenenamiento por serpiente venenosa, envenenamiento por veneno de serpiente, Envenenamiento por Serpiente
Portuguese Mordeduras de Serpentes, Envenenamento por Serpente, Acidente Ofídico, Mordedura de Cobra, Mordedura de Serpente, Mordidas de Cobra, Picadas de Cobras, Mordida de Cobra, Picada de Cobra, Picadas de Ofídios, Mordeduras de Serpente, Mordeduras de Cobra, Picada de Serpente, Acidentes Ofídicos, Envenenamento por Cobra, Picada de Serpentes, Picadas de Cobra, Picadas de Serpentes
Dutch beet; giftig, slang, Slangengif, Beet, slangen-, Beten, slangen-, Slangenbeet, Slangenbeetvergiftiging, Slangenbeten
Italian Morsi di serpente
French Envenimation par les serpents, Morsures de serpent
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Snake Venoms (C0037380)

Definition (MSH) Solutions or mixtures of toxic and nontoxic substances elaborated by snake (Ophidia) salivary glands for the purpose of killing prey or disabling predators and delivered by grooved or hollow fangs. They usually contain enzymes, toxins, and other factors.
Concepts Hazardous or Poisonous Substance (T131) , Biologically Active Substance (T123)
MSH D012910
SnomedCT 27831002
English Snake Venoms, Venoms, Snake, Snake Venom, Venom, Snake, Snake Venoms [Chemical/Ingredient], snake venom, snake venoms, venom snake, Snake venom, Snake toxin, Snake venom (substance), Snake toxin, NOS, Snake venom, NOS
Swedish Ormgifter
Czech hadí jedy
Finnish Käärmeenmyrkyt
Russian ZMEINYI IAD, IADY ZMEI, ЗМЕИНЫЙ ЯД, ЯДЫ ЗМЕЙ
French Venins de serpent
Croatian ZMIJSKI OTROVI
Polish Jady węży
Japanese 蛇毒(ジャドク), ヘビ毒, 蛇毒(ダドク), 蛇毒, ヤマカガシ毒
Spanish Ponzoñas de Serpiente, toxina de serpiente, veneno de serpiente (sustancia), veneno de serpiente, veneno de víbora, Venenos de Serpiente
German Gifte, Schlangen-, Schlangengifte, Toxine, Schlangen-
Italian Veleni dei serpenti
Portuguese Venenos de Serpentes
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Cottonmouth (C0206282)

Concepts Reptile (T014)
MSH D017836
SnomedCT 23448000
English Cottonmouth, Cottonmouths, cottonmouth, Agkistrodon piscivorus (Lacepede, 1789), Agkistrodon piscivorus, Agkistrodon piscivorus (organism)
Portuguese Boca de Algodão
Spanish Mocasin, Agkistrodon piscivorus (organismo), Agkistrodon piscivorus
French Agkistrodon piscivorus
German Wassermokassinschlange
Czech Agkistrodon piscivorus
Norwegian Vannmokasin
Italian Bocca di cotone
Dutch Watermocassinslang
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Micrurus (C0206287)

Concepts Reptile (T014)
MSH D017815
SnomedCT 376006, 55469004
English Coral Snake, Micrurus, Coral Snakes, Snake, Coral, Snakes, Coral, Coral snake, Micrurus (organism), Genus Micrurus (organism), Genus Micrurus, coral snake, micrurus, Coral snake (organism), American coral snake, Coral snake, NOS, Micrurus, NOS
Spanish género Micrurus, serpiente de coral americana, género Micrurus (organismo), Micrurus (organismo), Micrurus, serpiente coral, serpiente coral (organismo), Serpiente Coral
French Serpent corail, Micrurus
Portuguese Micrurus, Cobra Coral
German Micrurus, Korallenschlange
Norwegian Korallslange, Micrurus
Italian Micrurus, Serpente corallo
Dutch Koraalslang, Micrurus
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Copperhead (C0206310)

Concepts Reptile (T014)
MSH D017836
SnomedCT 54216008
English Copperheads, copperhead, Agkistrodon contortrix, Agkistrodon contortrix (organism), Copperhead, NOS, Copperhead
Portuguese Cabeça de Cobre
Spanish Cabeza Cobriza, Agkistrodon contortrix (organismo), Agkistrodon contortrix
German Kupferkopf
Czech Agkistrodon contortrix
French Mocassin à tête cuivrée
Norwegian Kopperhode
Italian Testa di rame
Dutch Koperkop
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Crotalus (C0206317)

Definition (MSH) A genus of snakes of the family VIPERIDAE, one of the pit vipers, so-called from the pit hollowing out the maxillary bone, opening between the eye and the nostril. They are distinctively American serpents. Most of the 25 recognized species are found in the southwestern United States and northern Mexico. Several species are found as far north as Canada and east of the Mississippi, including southern Appalachia. They are named for the jointed rattle (Greek krotalon) at the tip of their tail. (Goin, Goin, and Zug: Introduction to Herpetology, 3d ed; Moore: Poisonous Snakes of the World, 1980, p335)
Concepts Reptile (T014)
MSH D017839
SnomedCT 420914006, 81572007
English Rattlesnake, Crotalus, Rattlesnakes, Genus Crotalus (organism), Genus Crotalus, rattlesnake, rattlesnakes, crotalus, Rattlesnake (organism), Rattlesnake, NOS
Spanish género Crotalus, género Crotalus (organismo), Crotalus, serpiente cascabel (organismo), serpiente cascabel, Culebra Cascabel
French Crotale, Crotalus
Swedish Crotalus
Czech Crotalus, chřestýš
Finnish Kalkkarokäärme
Russian GREMUCHAIA ZMEIA, CROTALUS, ГРЕМУЧАЯ ЗМЕЯ
Italian Serpente a sonagli, Crotalo
Polish Grzechotniki właściwe
Japanese ガラガラヘビ属, ガラガラヘビ
Norwegian Klapperslanger, Crotalus
German Crotalus, Klapperschlange
Dutch Crotalus, Ratelslang
Portuguese Cascavel, Crotalus
Derived from the NIH UMLS (Unified Medical Language System)

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