[Adder bites]

Abstract

Introduction: The adder is the only poisonous snake in Denmark. Approximately five children and adults are each year hospitalized in Ringkoebing due to adder bites. The aim of this study was to illuminate who they are, under which circumstances they are bitten, their symptoms and treatment. What are the recommendations of treatment in the literature?

Material and methods: Historical review including patients who were discharged with the diagnosis DT 630 adder bite from Ringkoebing Hospital from January 1st 1995 through June 17th 2000.

Results: A total of 31 patients between two and 78 years of age were admitted to the hospital. 55% were 13 years old or less. Thirty of the patients were tourists in the area. The patients stayed in hospital for 20 hours on average. Common symptoms were edema, pain, nausea and signs of shock. 35% were moderately poisoned, the remaining were less affected. Symptomatic treatment was sufficient.

Discussion: The average time in hospital was shorter than in other reviews. Like in other reviews a frequent use of antibiotics and antihistamines, which do not correlate with recommendations in the literature, was found. All patients need observation for a minimum of six hours. Patients without symptoms can then be discharged with relevant anti-tetanus. Patients with symptoms should be observed for at least 24 hours. Treatment is symptomatic. Sheep-fab-fragment antivenom, ViperaTAb, which is less allergenic than other antivenoms on the market, should be employed in case of severe symptoms.