The Wilderness Medical Society convened an expert panel to develop a set of evidence-based guidelines for the prevention and treatment of North American pitviper envenomations. We present a review of pertinent pathophysiology, discuss prevention measures, and therapeutic management. Graded recommendations are made regarding each treatment and its role in management. These guidelines should assist in clinical decision making, but a “cookbook” approach is often insufficient, as each patient is unique and may respond differently to therapeutics.
