Treatment of bites by adders and exotic venomous snakes

doi:10.1136/bmj.331.7527.1244

BMJ 2005;331:1244-1247 (26 November), doi:10.1136/bmj.331.7527.1244

Clinical review

Treatment of bites by adders and exotic venomous snakes

David A Warrell, professor of tropical medicine and infectious diseases¹

¹ Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU david.warrell@ndm.oxford.ac.uk

The first 150 words of the full text of this article appear below.

Introduction

Every year, hundreds of people and unknown numbers of dogs andother domestic animals in England, Wales, and Scotland are bittenby our only indigenous venomous snake, the adder (Vipera berus)(fig 1). UK poisons centres are consulted about an average of100 human and a dozen veterinary cases each year. In about 70%of patients, envenoming is negligible or purely local, causingpain, swelling, and inflammation of the bitten digit. Only 14fatalities have been reported since 1876,¹ the last in a 5 yearold child in 1975,^w1 but adder bites should not be underestimated.On rare occasions, envenoming can be life threatening, especiallyin children, and many adults experience prolonged discomfortand disability after the bite.

Fig 1 Adder or viper (Vipera berus)

Apart from the exotic venomous snakes held legally by zoos,research establishments, and licensed private individuals, largenumbers of dangerous snakes . . . [Full text of this article]

Sources and selection criteria

Adder bites

Exotic snake bites

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

Technorati What's this?

Relevant Articles

How to treat snake bites
BMJ 2005 331: 0. [Full Text] [PDF]

One medicine?: Graham Easton and Martin Alder
BMJ 2005 331: 0. [Extract] [Full Text] [PDF]

Crotaline snake bite in the Ecuadorian Amazon: randomised double blind comparative trial of three South American polyspecific antivenoms: Roger Smalligan, Judy Cole, Narcissa Brito, Gavin D Laing, Bruce L Mertz, Steven Manock, Jeffrey Maudlin, Brad Quist, Gary Holland, Stephen Nelson, David G Lalloo, Gonzalo Rivadeneira, Maria Elena Barragan, Daniel Dolley, Michael Eddleston, David A Warrell, and R David G Theakston
BMJ 2004 329: 1129. [Abstract] [Full Text] [PDF]

Sequential randomised and double blind trial of promethazine prophylaxis against early anaphylactic reactions to antivenom for bothrops snake bites: Hui Wen Fan, Luiz F Marcopito, João Luiz C Cardoso, Francisco O S França, Ceila M S Malaque, Ronnei A Ferrari, Robert David G Theakston, and David A Warrell
BMJ 1999 318: 1451-1452. [Abstract] [Full Text] [PDF]

Low dose subcutaneous adrenaline to prevent acute adverse reactions to antivenom serum in people bitten by snakes: randomised, placebo controlled trial: A P Premawardhena, C E de Silva, M M D Fonseka, S B Gunatilake, and H J de Silva
BMJ 1999 318: 1041-1043. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

Warrell, D.A. (2009). Commissioned article: management of exotic snakebites. QJM 0: hcp075v1-hcp075 [Abstract] [Full text]
Malina, T., Krecsak, L., Warrell, D.A. (2008). Neurotoxicity and hypertension following European adder (Vipera berus berus) bites in Hungary: case report and review. QJM 101: 801-806 [Full text]
Suchithra, N, Pappachan, J M, Sujathan, P (2008). Snakebite envenoming in Kerala, South India: clinical profile and factors involved in adverse outcomes. Emerg. Med. J. 25: 200-204 [Abstract] [Full text]

Rapid Responses:

Read all Rapid Responses

Treatment of bites by adders and exotic venemous snakes: Alan W Fowler
bmj.com, 6 Dec 2005 [Full text]
Treatment of bites by adders and exotic venomous snakes: David A Warrell
bmj.com, 6 Jan 2006 [Full text]
David Warrell's clinical review: query: IMRE J. P. LOEFLER
bmj.com, 16 Feb 2006 [Full text]