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We conducted a retrospective review of  Vipera  spp. snakebite cases registered by the PCC of Bordeaux, France, between January 1, 2018, and December 31, 2020, evaluating the agreement between VipGrade ®  assessments, toxicologists’ assessments, and current guidelines. 133 patients with  Vipera aspis  snakebites were included. There was 100% agreement in severity grading by PCC guidelines and VipGrade ® . However, grading by toxicologists and VipGrade ®  diverged in 19 cases (85% agreement;  κ  = 0.80; 95% CI: 0.71 to 0.87). The VipGrade ®  tool’s grading reflects current PCC guidelines, which are authoritative in France, and may allow for a more rapid and standardized determination of management and follow-up of viper-bitten patients. It should be noted, however, that the more complex and dynamic aspects of management are not included in VipGrade ® . Its purpose is to supplement, not replace, the advice of the PCC’s clinical toxicologists, and this advice should be sought whenever a viper bite is encountered in clinical practice.

clinical toxicology

First step in assessment of VipGrade ® , a computerized clinical decision system to assess  Vipera  envenomation grading: a single-center interrater reliability study