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Adder bite — DIPIMC MCQ

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ModerateEnvironmental MedicineAdder biteDIPIMCDipIMC

A walker in the British countryside is bitten on the ankle by an adder. The area is swelling and painful, and he is otherwise well at present. What is the most appropriate immediate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Immobilise the limb and transfer for observation

For an adder bite, the limb should be immobilised and kept level with or below the heart, tight items removed, and the patient kept calm and transferred to hospital for observation and antivenom if systemic features develop. Tourniquets, incision and suction are harmful and outdated. Exertion such as brisk walking speeds venom spread, and applying and rubbing ice damages tissue. Pearl: mark the leading edge of swelling with the time to track progression during observation.

Reference: TOXBASE; JRCALC Clinical Guidelines