González D, Tauler E, Llorens J
An Esp Pediatr. 1980 Feb;13(2):151-56.
In the six cases described the injuries are localized in the superior limbs. In author's experience of 250 cases, all of them coming from rural areas, the poisoning occur from March to October, which is the period of activity for snakes in Spain. Only two of these cases have occured in a different time of the year. From the clinical cases described in the present paper, four were injured by "V. aspis" and two by "V. latasti". Most of the bites in our country are caused by the latter. The effects of the venoms, which can be classified as proteolytic, coagulant, hemolytic and neurotoxic, depend on a great variety of enzymatic proteins which, synthesized by the parotid glands, the snakes inject at the time of biting. Management of patients poisoned by vipers consists, locally in suctioning the venom without using any tourniquets and debridements. Systemic treatment consists in administering antihistaminics, corticoids and antibiotics. Specific treatment is the antivenom serum.