NCEMI eTools

Crotalid snakebite severity score
A research tool for scoring the severity of crotalid snake bites in adults. It correlated well with physician assessment of severity.
Score: 0
Minimal severity
Assessment
<2Minimal severity
2-3Moderate severity
4-8More severe
>8Very severe
 
Pulmonary system
No symptoms/signs 0 points
Dyspnea, minimal chest tightness or discomfort, or respiratory rate 20-25 1 points
Moderate respiratory distress (tachypnea, 26-40 breaths/minute, accessory muscle use 2 points
Cyanosis, air hunger, extreme tachypnea, or respiratory failure 3 points
Cardiovascular system
 
Local wound
No symptoms/signs 0 points
Pain, swelling, or ecchymosis within 5-7.5 cm of bite 1 points
Pain, swelling, or ecchymosis involving less than half the extremity (7.5-50 cm from bite site) 2 points
Pain, swelling, or ecchymosis involving half to all of extremity (50-100 cm from bite site) 3 points
Pain, swelling, or ecchymosis extending beyond affected extremity (over 100 cm from bite site) 4 points
 
Gastrointestinal symptoms
No symptoms/signs 0 points
Pain, tenesmus, or nausea 1 points
Vomiting or diarrhea 2 points
Repeated vomiting, diarrhea, hematemesis, or hematochezia 3 points
 
Hematologic system
No abnormalities 0 points
Slightly abnormal (PT under 20s; PTT under 50s; Platelets 100K-150K; or fibrinogen 100-150 mcg/mL) 1 points
Abnormal (PT 20-50s, PTT 50-75s, platelets 50K-100K, or fibrinogen 50-100 mcg/mL 2 points
Very abnormal (PT 50-100s, PTT 75-100s, platelets 20K-50K, or fibrinogen under 50 mcg/mL) 3 points
Markedly abnormal, with serious bleeding or its threat. Unmeasurable PT or PTT, or platelets under 20K, or undetectable fibrinogen, or other severe lab abnormalities 4 points
 
Central nervous system
No symptoms/signs 0 points
Minimal apprehension, headache, weakness, dizziness, chills or paresthesia 1 points
Moderate apprehension, headache, weakness, dizziness, chills, paresthesia, confusion, or fasciculation at bite 2 points
Severe confusion, lethargy, seizures, coma, psychosis or generalized fasciculation 3 points
Calculate

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