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Arch Emerg Med. 1993 December; 10(4): 375–379.
PMCID: PMC1286055

Adder (Vipera berus) bites: a case report and review of the management for emergency medical personnel.


Few doctors working in the accident and emergency (A&E) department will have had experience in the management of adder (Vipera Berus) bites. While such events are uncommon, and rarely fatal, prompt correct management undoubtedly helps in reducing mortality and morbidity. Various isolated case reports (Watson & Harland, 1977; Gerard & Pugh, 1982; Jones & Clegg, 1985) and larger reviews (Reid, 1976; Pesson & Irestedt 1981; Hawley, 1988, 1990) have appeared in non A&E related journals. Following our own recent experience we felt it timely to report our case and review the management.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Gerrard M, Pugh R. An adder bite with unusual consequences. Practitioner. 1982 Mar;226(1365):527–528. [PubMed]
  • Hawley A. Adder bite in the British Army 1979-1988: a decade of experience. J R Army Med Corps. 1990 Jun;136(2):114–118. [PubMed]
  • Jones TI, Clegg W. Management of Vipera berus adder bite. Practitioner. 1985 Nov;229(1409):956–958. [PubMed]
  • Moore RS. Second-degree heart block associated with envenomation by Vipera berus. Arch Emerg Med. 1988 Jun;5(2):116–118. [PMC free article] [PubMed]
  • Persson H, Irestedt B. A study of 136 cases of adder bite treated in Swedish hospitals during one year. Acta Med Scand. 1981;210(6):433–439. [PubMed]
  • Atkinson TP, Kaliner MA. Anaphylaxis. Med Clin North Am. 1992 Jul;76(4):841–855. [PubMed]
  • Reid HA. Adder bites in Britain. Br Med J. 1976 Jul 17;2(6028):153–156. [PMC free article] [PubMed]
  • Watson AA, Harland WA. Adder-bite fatality in Scotland. Med Sci Law. 1977 Jul;17(3):190–192. [PubMed]

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