[Snake bites by Italian viperids: diagnosis and therapy].

In Italy ophidiasis by viper snakes seems to be in light, but in continuous increase; may be the mortality is to be inferior to one per cent, even if there aren't any reliable statistics. The Authors, finding embarrassment and unpreparedness from the Italian physician in such a situation, intend to provide with this work a correct diagnostic-therapeutic iter to be followed in a case of snakebite. Here are reported and discussed the essential data for the diagnosis of viper bite: snake identification, wound inspection, local and general symptomatology, laboratory data and principal complications. Afterwards, they face the treatment, dividing it in interventions to be always effected and if necessary; they suggest to treat hypovolemic shock with an dopamine intravenous infusion (in more serious cases: antiophidic serum). The Authors illustrate the cases where they can use the antivenom, indicating doses, administration modalities and therapy of the incidental anaphylaxis; besides they warn its abuse, that in Italy seems to be rather frequent and totally unjustified.