The adder, the only indigenous poisonous snake found in England, Scotland and Wales, bites hundreds of people, dogs and other animals yearly.UK poisons centers are consulted on an average of 100 human and a dozen veterinary cases each year. About 70% of patients suffer no real problems except some pain, swelling and redness where bitten. Only 14 fatalities have been reported since 1876. Occasionally being bitten by the adder can be life threatening, especially in children. Many adults experience prolonged discomfort and disability after the bite. Adder bites are common throughout mainland Britain and some islands off the west coast of Scotland. Bites start occurring in February and stop in October, peaking in June to August. Half the patients are bitten on the hand while picking up the adder. The pain starts within a few minutes after the bite, usually peaking within 30 minutes. Occasionally, tingling and local swelling occurs, with tenderness and inflammation following. These symptoms can be more serious in children, with extensive swelling and bruising up to 24 hours after the bite.
Instructions
1. Do first aid. Reassure the patient that he will be fine. Give paracetamol (Feverall in the United States) for pain and immobilize the patient. Transport the patient to a hospital immediately. In severe cases, use epinephrine (Epi-Pen) to avoid anaphylactic shock. Do not use tourniquets, ligatures or compression bandages.
2. Get hospital treatment. Clinical assessment will happen in a hospital. If any antivenom is needed, the decision will be made at this time. Hospital staff will carefully monitor blood pressure and watch for signs of worsening poisoning problems.
3. Check for hypotension with or without signs of shock. Swelling that is either extensive or rapidly spreading calls for two ampules of Zagreb antivenom by slow intravenous injection of infusion. If no clinical improvement has occurred after one hour, two more ampules of antivenom will be given.
4. Intravenous fluids or blood transfusion may be needed in extreme poisonings. If necessary, rehabilitation physiotherapy should be started as early as possible.
5. Recovery takes less than a week in children. Adults can take as long as three weeks to become symptom free.
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