Bungarus flaviceps ( Red headed Krait )
Original photo copyright © Dr Julian White
Family: Elapidae
Subfamily: Elapinae
Genus: Bungarus
Species: flaviceps
Subspecies: flaviceps , baluensis
Common Names: Red-headed Krait , Yellow-Headed Krait
, Kinabalu Krait ( B. f. baluensis )
Local Names: Ular Katang Kepala Merah
Region: Southeast Asia
Countries: Brunei, Cambodia, Indonesia,
Malaysia, Myanmar, Thailand, Vietnam
Bungarus flaviceps ( Red headed Krait ) Original photo copyright © Dr Julian White
Taxonomy and Biology
Adult Length: 1.00 m
General Shape: Large in length, moderately slender
bodied snake with a triangular shaped cross-section ( pronounced ridge on the
vertebral line ) with a short tail ending in a pointed tip. Can grow to a
maximum of about 1.93 metres. Head is flat and slightly distinct from neck. Eyes
are small in size and black with a barely visible round pupils. Nostrils are
large. Dorsal scales are smooth and glossy without apical pits and with the
vertebral scale row enlarged. Dorsal scale count 13 - 13 - 13.
Habitat: Tropical wet lowland, mountain and foothill
primary and secondary forest regions at elevations up to about 950 metres. Also
found in and around some human settlements.
Habits: Nocturnal and strictly terrestrial. Slow
moving, but if provoked raises its head and waves its tail quite slowly.
Reluctant to bite except under extreme provocation.
Prey: Feeds mainly on snakes, lizards and frogs.
Venom
General: Venom Neurotoxins
|
Pre- & Post-synaptic neurotoxins
|
General: Venom Myotoxins
|
Not present
|
General: Venom Procoagulants
|
Not present
|
General: Venom Anticoagulants
|
Not present
|
General: Venom Haemorrhagins
|
Not present
|
General: Venom Nephrotoxins
|
Not present
|
General: Venom Cardiotoxins
|
Not present
|
General: Venom Necrotoxins
|
Not present
|
General: Venom Other
|
Not present or not significant
|
Clinical Effects
General: Dangerousness
|
Severe envenoming possible, potentially lethal
|
General: Rate of Envenoming
|
Unknown but likely to be low
|
General: Untreated Lethality Rate
|
Unknown but lethal potential cannot be excluded
|
General: Local Effects
|
None or minimal
|
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
|
Very common, flaccid paralysis is major clinical effect
|
General: Myotoxicity
|
Not likely to occur
|
General: Coagulopathy & Haemorrhages
|
Unlikely to occur
|
General: Renal Damage
|
Unlikely to occur
|
General: Cardiotoxicity
|
Unlikely to occur
|
General: Other
|
Not likely to occur
|
First Aid
Description: First aid for bites by Elapid snakes
which do not cause significant injury at the bite site, but which may have the
potential to cause significant general (systemic) effects, such as paralysis,
muscle damage, or bleeding.
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. 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.
Treatment
Treatment Summary: Krait bites can cause
moderate to severe flaccid paralysis, respiratory failure, requiring intubation
& ventilation in severe cases. Antivenom available for major species, may
prevent worsening of paralysis, but may not reverse established paralysis.
Key Diagnostic Features: Minimal to mild local
reaction + 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: Only antivenoms
available are for related species, but should be used for significant
envenoming
Antivenoms
1.
Antivenom Code: SAsTRC04
Antivenom
Name: Banded Krait Antivenin
Manufacturer:
Science Division, Thai Red Cross Society
Phone:
++66-2-252-0161 (up to 0164)
Address:
Queen Saovabha Memorial Institute
1871 Rama
IV Road
Pathumwan
Bangkok
10330
Country:
Thailand
Source: Clinical
Toxinology Resources
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