A study of the treatment of pit viper envenomization in 45 patients.

Forty-five patients with snake bite were studied: 33 were classified nontoxic and 12 toxic. There were no deaths and four complications in the nontoxic group; two deaths and three complications in the toxic group. The data suggest that rapid recovery is generally to be expected in nontoxic patients regardless of the form of local therapy. The risk of antivenin complications outweighs the minimal therapeutic benefits when administered to most nontoxic patients. If nausea and vomiting are the only manifestations of systemic toxicity antivenin may not be necessary for rapid and complete recovery. The combination of hypotension and bleeding diathesis represents a particularly severe form of toxicity that may result in death if adequate systemic and supportive therapy is not rapidly instituted.