Jiann-Ruey Ong, MD; Hon-Ping Ma, MD; Tzong-Luen Wang, MD, PhD

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Abstract ---Snakebites are not uncommon in Taiwan. There are 23 venomous snake with 6 most common encountered here. Annual report of snakebites is about 300~600 with mortality of 10~20. Traditional classification of venom by hematoxin or neurotoxin is still useful in initial clinical management. Severe envenomation occurred in less than 5%. First aids in the field and prompt deliver to nearest capable facilities for medical care or administration of antivenom greatly reduce the morbidity and mortality. History of exposure, local effect and systemic syndromes of envenomation, progression of symptoms and signs, laboratory data obtained in emergency department should guide the decision for antivenom therapy. Coagulopathy with shock and respiratory failure is the main complications. Aggressive supportive treatment for possible complications of snakebites and allergic reaction of antivenom therapy is the mainstay of management.