Usually at least 2-3 ampoules of CSL Tiger Snake Antivenom will be needed. FFP is generally not needed and should not be used if there is still circulating venom, except if there is major, life threatening haemorrhage. Kidney damage does occur, though less commonly than with brown snake bites, and causation is multifactorial, due to secondary factors such as myolysis and coagulopathy. Copperhead bites are only infrequently reported and there is a paucity of good clinical data. From available information it appears that the common copperhead can cause severe envenoming, with paralysis and possibly myolysis, but defibrination type coagulopathy is unlikely, though secondary kidney damage might occur.
Bites are likely to cause local pain and swelling.
For the pygmy copperhead in SA, all bites so far recorded have been minor, with minimal local pain or swelling and no significant systemic effects. However, this does not imply that every bite will be minor. Rough scaled snake bites can be severe, with local pain and swelling, paralysis, myolysis, defibrination coagulopathy and secondary kidney damage. Bites by black snakes are rarely life threatening and do not cause paralysis, defibrination coagulopathy or major myolysis. They are discussed in more detail below, in indications for antivenom use.