Aim. To investigate the degree to which primary and secondary care physicians in the Herzegovina region follow the protocols recommended in the literature for treatment of patients bitten by a venomous snake.

Method. We retrospectively examined hospital records of all patients treated at the Department of Infectious Diseases, Mostar University Hospital, for intoxication following a venomous snakebite in the 1997-2002 period. The data on demographic characteristics, clinical presentation, therapy protocols, and final outcome were collected for each patient.

Results. From 1997 to 2002, 43 men (60.5%) and 28 women (33.4%) were treated at our Department for a venomous snakebite. The greatest number of snakebites occurred in persons older than 60 (chi-square= 12.44, df= 3, p= 0.006) and during the summer months (chi-square= 8.12, df= 1, p= 0.004). More than half of the patients (38, or 53.5%) were bitten on the hand. The commonest symptoms and signs of the local envenomation were pain (97.1%) and swelling (87.3%), whereas general symptoms were tachycardia (39.4%), nausea (33.8%), and vomiting (28.1%). Also, 56 patients (78.8%) experienced anxiety and fear. The primary care protocol recommended in the literature (antibiotics, tetanus antitoxin, snakebite antiserum, and immobilization) was given to only 2 patients (2%). However, there were no lethal outcomes.

Conclusion. Development of a precise evidence-based protocol for prehospital management of venomous snakebite is needed in the Herzegovina region, followed by educational efforts targeted at primary care physicians.