Envenomation symptoms begin with pain at the site of the bite, immediately followed by swelling of the affected extremity. Bleeding is a common symptom, especially from the gums and in the urine, and sputum may show signs of blood within 20 minutes after the bite. The blood pressure drops, and the heart rate falls. Blistering occurs at the site of the bite, developing along the affected limb in severe cases. Necrosis is usually superficial and limited to the muscles near the bite, but may be severe in extreme cases. Vomiting and facial swelling occur in about one-third of all cases. Kidney failure (renal failure) also occurs in approximately 25-30 percent of untreated bites. Severe disseminated intravascular coagulation also can occur in severe envenomations. Early medical treatment and early access to antivenom can prevent and drastically reduce the chance of developing the severe/potentially lethal complications.