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Table 2 Clinical progression of edema and bleeding for viper envenomations in Benin

From: Delayed double reading of whole blood clotting test (WBCT) results at 20 and 30 minutes enhances diagnosis and treatment of viper envenomation

  Edema Bleeding
Stage 1 Does not extend beyond wrist/ankle Persistent atraumatic bleeding from the bite wound >1 h
Stage 2 Does not extend beyond major joints (elbow/knee) Bleeding from old cuts and wounds elsewhere on patient
Stage 3 Extends beyond major joints Spontaneous bleeding from healthy mucosa (i.e. gingiva)
Stage 4 Reaches but does not extend beyond multiaxial joints (shoulder/hip) Externalization of internal bleeding (hematemesis, melena, etc.)
Stage 5 Extensive edema beyond multiaxial joints Cerebral, meningeal, intra-abdominal, or retroperitoneal hemorrhage; critical hemorrhagic shock