Next Article in Journal
Binding of Natural and Synthetic Inhibitors to Human Heat Shock Protein 90 and Their Clinical Application
Previous Article in Journal
A Primary Primitive Neuroectodermal Tumor of the Central Nervous System in a 51-year-old Woman: a Case Report and Literature Review
Medicina is published by MDPI from Volume 54 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:

Venomous Snakebites

Dalia Adukauskienė
Eglė Varanauskienė
2 and
Agnė Adukauskaitė
Department of Intensive Care, Medical Academy, Lithuanian University of Health Sciences
Department of Endocrinology, Medical Academy, Lithuanian University of Health Sciences
Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, Lithuania
Author to whom correspondence should be addressed.
Medicina 2011, 47(8), 461;
Submission received: 5 November 2010 / Accepted: 31 August 2011 / Published: 5 September 2011


More than 5 million people are bitten by venomous snakes annually and more than 100 000 of them die. In Europe, one person dies due to envenomation every 3 years. There is only one venomous snake species in Lithuania – the common adder (Vipera berus) – which belongs to the Viperidae family; however, there are some exotic poisonous snakes in the zoos and private collections, such as those belonging to the Elapidae family (cobras, mambas, coral snakes, etc.) and the Crotalidae subfamily of the Viperidae family (pit vipers, such as rattlesnakes). Snake venom can be classified into hemotoxic, neurotoxic, necrotoxic, cardiotoxic, and nephrotoxic according to the different predominant effects depending on the family (i.e., venom of Crotalidae and Viperidae snakes is more hemotoxic and necrotoxic, whereas venom of Elapidae family is mainly neurotoxic). The intoxication degree is estimated according to the appearance of these symptoms: 1) no intoxication (“dry” bite); 2) mild intoxication (local edema and pain); 3) moderate intoxication (pain, edema spreading out of the bite zone, and systemic signs); 4) severe intoxication (shock, severe coagulopathy, and massive edemas). This topic is relevant because people tend to make major mistakes providing first aid (e.g., mouth suction, wound incision, and application of ice or heat). Therefore, this article presents the essential tips on how first aid should be performed properly according to the “Guidelines for the Management of Snake-Bites” by the World Health Organization (2010). Firstly, the victim should be reassured. Rings or other things must be removed preventing constriction of the swelling limb. Airway/breathing must be maintained. The bitten limb should be immobilized and kept below heart level to prevent venom absorption and systemic spread. Usage of pressure bandage is controversial since people usually apply it improperly. Incision, mouth suction, or excision should not be performed; neither a tourniquet nor ice or heat should be applied. A doctor must monitor respiratory rate, blood pressure, heart rate, renal function, fluid balance, and coagulation status. The only specific treatment method is antivenin – serum with antibodies against antigens of snake venom. Antivenins against pit vipers used in the United States are Antivenin Crotalidae Polyvalent (ACP) and a more purified and hence causing less adverse reactions – Crotalidae Polyvalent Immune Fab (CroFab). In Europe, a polyvalent antiserum against Viperidae family snakes (including the common adder) can be used. Antivenins often may cause severe hypersensitivity reactions because of their protein nature. The bite of the common adder (the only poisonous snake in such countries as Lithuania and Great Britain) relatively rarely results in death; thus, considering the risk of dangerous reactions the antivenin causes itself, the usage of it is recommended to be limited only to life-threatening conditions.
Keywords: venomous snakebites; first aid; treatment venomous snakebites; first aid; treatment

Share and Cite

MDPI and ACS Style

Adukauskienė, D.; Varanauskienė, E.; Adukauskaitė, A. Venomous Snakebites. Medicina 2011, 47, 461.

AMA Style

Adukauskienė D, Varanauskienė E, Adukauskaitė A. Venomous Snakebites. Medicina. 2011; 47(8):461.

Chicago/Turabian Style

Adukauskienė, Dalia, Eglė Varanauskienė, and Agnė Adukauskaitė. 2011. "Venomous Snakebites" Medicina 47, no. 8: 461.

Article Metrics

Back to TopTop