Emergency treatment of adder bites: case reports and literature review.

Five cases of adder bites are presented. The clinical effects and current recommendations for the treatment of adder bites are described based on a review of previously published literature. All adder bites, or snake bites of unknown species, should be observed for a minimum of 2 h. Those with no local swelling may be allowed home with appropriate antitetanus prophylaxis. Patients with local reaction or signs of systemic envenoming should be admitted for 48 h with ECG monitoring, and antivenom obtained. Indications and precautions for administration of antivenom are reviewed. Early antivenom treatment may reduce mortality and morbidity from adder bites.