50 Years Ago in The Journal of Pediatrics


Sadan M, Soroker B. Observations on the effects of the bite of a venomous snake on children and adults. J Pediatr 1970;76:711-5.

In the early 1970s, it was believed that the effects of snakebite from a venomous species were more severe in children than in adults. This was due to the assumption that children would receive a proportionately larger amount of venom when bitten than the adult. During the past decades, several countries have reported their statistics over the severity and mortality from snakebites. During multiple retrospective studies, the medical community began to notice that the severity of illness and the mortality induced from venomous snakebite were greater in the adult population, noticing that both populations had minimal venenation, with severe reactions and deaths involving mostly adults.

The classification for the grade of venenation may vary, but it differentiates the bites from mild, moderate, and severe cases. The early classification and identification of symptoms has remained until this day the most important outpatient and inpatient basis to determine the morbidity and mortality of the patients. Sadan and Soroker show that most patients receive medical attention during the first stage of the snakebite, granting discharge of the patient at early stages, and avoiding complications or progression of the venenation. It is also evident that most patients who have fatal outcomes presented a delay in medical attention (delayed arrival at hospital, attention in an under qualified unit, etc).1x1Martín-Sierra, C., Nogué-Xarau, S., Pinilos Echeverría, M.A., and Rey Pecharromán, J.M. Envenenamiento por mordedura de serpiente en España. Emergencias. 2018;
30: 126–132
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It has been established that the species of venomous snakes vary from region and climate. Most venomous species are identified and most common bites have specific antidotes. This is extremely important because most mortal victims had a delay in medical attention. Most fatal victims presented with coagulopathies such as bleeding from bite site, hematuria, and melena during the first 24 hours, eventually progressing to shock and or acute renal failure.2x2Harmon, K.J., Haskell, M.G., Mann, C.H., and Waller, A.E. Snakebites treated in North Carolina Emergency Departments, October 2013–September 2015. Wilderness Environ Med. 2018;
29: 176–184
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The understanding of the effects of snakebites have evolved during this past 50 years, allowing the medical community to develop, improve, and offer adequate medical attention. It must remain a priority in endemic regions, and we have to avoid serious complications.

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