Boomslang bite--diagnosis and management. A report of 2 cases

Bites by boomslang are uncommon and usually occur in adult snake handlers who are aware of the potentially fatal consequences, i.e. disseminated intravascular coagulation with delayed onset of spontaneous haemorrhage. Accidental bites in children are rare. Aids to diagnosis include the description of the bite, identification of the snake, and the recognition of an abnormal bleeding tendency before the onset of spontaneous haemorrhage. Specific boomslang antivenin arrests established bleeding but may not be immediately available, in which case the administration of heparin should be considered. Thrombo-elastography is a useful aid to diagnosis and management.