A study of the knowledge and attitudes of emergency physicians and plastic surgeons in the management of snakebites

Snakebites in the UK are uncommon. In the UK and Europe, they occur less frequently compared to the Americas, Africa and Asia. In the UK, there is only one known indigenous poisonous snake, Vipera berus, the adder, but other snake species may be found in private collections or zoos. Snakebites in the UK tend to occur in certain ‘hotspots’ namely rural areas, forestry or in national parklands; parts of Scotland, Wales and the counties of Norfolk, Devon and Cornwall where the largest population of snakes exist. In the UK, the majority of snakebites are managed by emergency physicians; however, a small but significant proportion can develop complications which necessitate management by plastic and reconstructive surgeons and/or other medical specialists. Fortunately in the UK, very few indigenous snakes envenomate; therefore, we do not see the devastating and, in some cases, fatal consequences of snakebites including the cardiovascular, neurological and cutaneous sequelae. The objective of the survey performed was to provide insight into the knowledge and attitude of emergency physicians and plastic surgeons in the management of snakebites. In general, there was a good level of previous experience of managing snakebites abroad in the vast majority of cases. However, the survey findings indicated poor knowledge of the consequences of snakebites and the administration of antivenom. The authors feel better awareness and training for clinical staff who may be asked to deal with such problems would be of great benefit. Further, public awareness for holiday makers should be improved in an effort to reduce the numbers of snakebites which commonly occur in the UK.