The diagnosis of snakebite is based on the presence of fang marks and a history consistent with exposure to a snake (walking through a field, etc.). Snake envenomation involves the presence of a snake bite plus evidence of tissue injury. Clinically, the injury may be manifest in three ways: local injury (swelling, pain, ecchymosis), coagulopathy (thrombocytopenia, elevated prothrombin time, hypofibrinoginemia), or systemic effects (oral swelling or paresthesias, metallic or rubbery taste in the mouth, hypotension, tachycardia, etc.). Abnormalities in any one of these areas indicate that venom effect is developing. The absence of all three manifestations for a period of 8 to 12 h following the bite indicates that no venom was injected.
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