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Title: Snakebite in Australia: a practical approach to diagnosis and treatment.
Austin Authors: Isbister, Geoffrey K;Brown, Simon G A;Page, Colin B;McCoubrie, David L;Greene, Shaun L ;Buckley, Nicholas A
Affiliation: Emergency Department and Victorian Poisons Information Centre, The Austin Hospital, Melbourne, VIC, Australia
Discipline of Clinical Pharmacology, University of Newcastle, Newcastle, NSW, Australia
NSW Poisons Information Centre, Sydney Children's Hospital Network, Sydney, NSW, Australia
Centre for Clinical Research in Emergency Medicine, Western Australian Institute for Medical Research, Royal Perth Hospital and University of Western Australia, Perth, WA, Australia
Emergency Department, Royal Perth Hospital, Perth, WA, Australia
Emergency Department, Princess Alexandra Hospital, Brisbane, QLD, Australia
Issue Date: 16-Dec-2013
Publication information: Medical Journal of Australia; 199(11): 763-8
Abstract: Snakebite is a potential medical emergency and must receive high-priority assessment and treatment, even in patients who initially appear well. Patients should be treated in hospitals with onsite laboratory facilities, appropriate antivenom stocks and a clinician capable of treating complications such as anaphylaxis. All patients with suspected snakebite should be admitted to a suitable clinical unit, such as an emergency short-stay unit, for at least 12 hours after the bite. Serial blood testing (activated partial thromboplastin time, international normalised ratio and creatine kinase level) and neurological examinations should be done for all patients. Most snakebites will not result in significant envenoming and do not require antivenom. Antivenom should be administered as soon as there is evidence of envenoming. Evidence of systemic envenoming includes venom-induced consumption coagulopathy, sudden collapse, myotoxicity, neurotoxicity, thrombotic microangiopathy and renal impairment. Venomous snake groups each cause a characteristic clinical syndrome, which can be used in combination with local geographical distribution information to determine the probable snake involved and appropriate antivenom to use. The Snake Venom Detection Kit may assist in regions where the range of possible snakes is too broad to allow the use of monovalent antivenoms. When the snake identification remains unclear, two monovalent antivenoms (eg, brown snake and tiger snake antivenom) that cover possible snakes, or a polyvalent antivenom, can be used. One vial of the relevant antivenom is sufficient to bind all circulating venom. However, recovery may be delayed as many clinical and laboratory effects of venom are not immediately reversible. For expert advice on envenoming, contact the National Poisons Information Centre on 13 11 26.
Gov't Doc #: 24329653
Journal: Medical Journal of Australia
Type: Journal Article
Subjects: Animals
Antivenins.therapeutic use
Elapid Venoms.toxicity
First Aid.methods
Immunologic Factors.therapeutic use
Snake Bites.complications.diagnosis.therapy
Appears in Collections:Journal articles

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