Five cases of adder bites are presented. The clinical effects and curr
ent recommendations for the treatment of adder bites are described bas
ed 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 a
ntitetanus prophylaxis. Patients with local reaction or signs of syste
mic envenoming should be admitted for 48 h with ECG monitoring, and an
tivenom obtained. Indications and precautions for administration of an
tivenom are reviewed. Early antivenom treatment may reduce mortality a
nd morbidity from adder bites.