Adder bites or bite

The adder or viper (Vipera berus) is common throughout mainland Britain and some of the islands off the west coast of Scotland

• bites occur from February to October, peaking in June to August (1)
• about 50% of patients are bitten on the hand whilst picking up the adder
• be very reassuring as most victims are very frightened. Venom is often not injected and, when it is, reactions are often local and mild
• give paracetamol to control pain
• refer urgently to casualty department
• do not suck the wound
• immobilise the patient during urgent transfer to casualty department
• splint the arm or leg to reduce dispersal while waiting for hospital antivenom treatment if needed
• tourniquets, compression bandages and ligatures should not be used (1)
• anaphylaxis occurs in a small number of patients
• bites of foreign snakes require specialist advice and may need antiserum

Reference:

1. Warrell DA. Treatment of bites by adders and exotic venomous snakes. BMJ 2005; 331:1244-47