[Young reptile lover bitten by viper]. / Adder bijt jonge reptielenliefhebber.

In the summer, an 11-year-old boy is bitten in his hand by a viper during survival camp. With extreme pain, swelling, vomiting and eventually loss of consciousness, he ends up in the emergency room. In the medium care, the arm swelling appears to be progressive. Antiserum delivered by express courier is finally given. Tourniquets, ice, incising and aspiration are obsolete. Gentle bandages with mild compression and a splint are an option. Immobilization is also important and haste depends on the symptoms (in 2 to 50% there is a 'dry bite'). Antiserum is given immediately in case of systemic effects such as coagulation disorder, dyspnoea, hypovolemic shock and renal insufficiency. In case of swelling, one should wait and see and determine the extent and progression of the swelling when antiserum is used. When administering the antiserum, a solid anticipation of anaphylaxis belongs.

[What do you think of Thuisarts.nl? Experiences after 3 years of www.Thuisarts.nl]. / Thuisarts.nl, hoe bevalt dat? Ervaringen na 3 jaar Thuisarts.nl.

Many people need information on health and disease, but the internet is a maze of medical information. In order to offer patients reliable medical information, and to support general practitioners, the Dutch College of General Practitioners (NHG) set up the public website Thuisarts.nl in 2011, which was later followed by an app. The NHG members survey amongst general practitioners from June 2013 showed that 90% of the general practitioners used Thuisarts.nl. The number of visitors was on average 60,000 a day. Information is also available from questionnaires filled in by the NIVEL Health Care Consumer Panel (n = 2846) and participants in a study on information technology and independence (n = 25). Thuisarts.nl meets an important need and is highly valued by doctors and patients. There are plans for the further development of Thuisarts.nl including short videos, illustrations, searchable anatomical structures and information from other reliable organisations such as associations of specialist doctors.