Research Article The Protocol of Choice for Treatment of Snake Bite Afshin Mohammad Alizadeh, 1 Hossein Hassanian-Moghaddam, 2,3 Nasim Zamani, 2,3 Mitra Rahimi, 2,3 Mohammad Mashayekhian, 2 Behrooz Hashemi Domeneh, 2 Peyman Erfantalab, 2,4 and Ali Ostadi 2,5 1 Department of Bone Marrow Transplantation, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2 Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 3 Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran 4 Department of Emergency Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran 5 Department of Internal Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Correspondence should be addressed to Hossein Hassanian-Moghaddam; hassanian@sbmu.ac.ir Received 15 April 2016; Revised 3 August 2016; Accepted 18 August 2016 Academic Editor: Giovanni Storto Copyright © 2016 Afshin Mohammad Alizadeh et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Te aim of the current study is to compare three diferent methods of treatment of snake bite to determine the most efcient one. To unify the protocol of snake bite treatment in our center, we retrospectively reviewed fles of the snake-bitten patients who had been referred to us between 2010 and 2014. Tey were contacted for follow-up using phone calls. Demographic and on- arrival characteristics, protocol used for treatment (WHO/Haddad/GF), and outcome/complications were evaluated. Patients were entered into one of the protocol groups and compared. Of a total of 63 patients, 56 (89%) were males. Five, 19, and 28 patients were managed by Haddad, WHO, or GF protocols, respectively. Eleven patients had fallen into both GF and WHO protocols and were excluded. Serum sickness was signifcantly more common when WHO protocol was used while 100% of the compartment syndromes and 71% of deformities had been reported afer GF protocol. Te most important complications were considered to be deformity, compartment syndrome, and amputation and were more frequent afer the use of WHO and GF protocols (23.1% versus 76.9%; none in Haddad;  = NS). Haddad protocol seems to be the best for treatment of snake-bitten patients in our region. However, this cannot be strictly concluded because of the limited sample size and nonsignifcant  values. 1. Introduction Snake bite is a common and very important health problem in many parts of the world including our country [1, 2]. Apart from the production of antivenom, snake envenomation shares all characteristics of a neglected tropical disease in Asia [3]. Snake bite has caused almost from 4.5 to 9.1 efect rate in each 100000 Iranian population and 67 deaths (0.1% mortality rate) during 2002 to 2011 [2]. Although mortality rate of snake bite is fairly low, the complications due to it or its treatment (including coagulopathies, renal and/or pulmonary fail- ure, disseminated intravascular coagulopathy, hemorrhages, deformities, compartment syndrome, limb amputation, and serum sickness syndrome) are rather frequent [1, 4]. Diferent protocols exist to manage snake bite, some of the very commonly used ones of which are the protocols suggested by the World Health Organization (WHO), Gold- frank’s Toxicologic Emergencies (GF) textbook (Figure 1), and Haddad and Winchester’s (Haddad) Clinical Management of Poisoning and Drug Overdose textbook (Figure 2) [5–7]. Interestingly, these protocols are far diferent from each other regarding management of the patients and even in the determination of the severity of poisoning (Table 1) [6, 7]. Tey all have their own fans. No study has compared the efcacy of these protocols to determine the most efcient one with the least complications. In Iran, of three types of antivenom, only polyvalent one is produced by the Razi Vaccine and Serum Research Hindawi Publishing Corporation Advances in Medicine Volume 2016, Article ID 7579069, 5 pages http://dx.doi.org/10.1155/2016/7579069