Effects of Australian snake bite venom are usually
species specific, but in general include:
■ neurotoxins
■ procoagulants
■ anti-coagulants
■ rhabdomyolysins
■ haemolysins (weak).
Presentation
Symptoms and signs of
envenomation may include:
■ EARLY (within 30 minutes)
- headache, nausea/vomiting,
abdominal pain
- coagulopathy
■ LATE (within several hours)
- cranial nerve palsies
(ptosis, ophthalmoplegia,
dysarthria, dysphonia,
dysphagia)
- limb and truncal weakness
- respiratory failure
- haemorrhage
■ VERY LATE (delayed
presentation,
wrong/inadequate treatment)
- prolonged paralysis
- renal failure
- uncontrollable haemorrhage
Features suggestive of snakebite
Identification of snakes is often
unreliable: polyvalent antivenom
should be used if the
type of snake cannot be identified
in all areas of Australia
apart from Tasmania, where
both tiger snake and copperhead
bite may be successfully
treated with tiger snake
antivenom, and Victoria, where
bites should be treated with
combined tiger/brown snake
antivenom
How to treat
Identification of snakes is often
unreliable: polyvalent antivenom
should be used if the
type of snake cannot be identified
in all areas of Australia
apart from Tasmania, where
both tiger snake and copperhead
bite may be successfully
treated with tiger snake
antivenom, and Victoria, where
bites should be treated with
combined tiger/brown snake
antivenom.
Important to remember
■ Correct diagnosis of snakebite
may be delayed because the
bite may not be dramatic or
painful, and snake venom
generally causes little local
pain or tissue destruction.
■ Identification of snakes is often
unreliable: polyvalent
antivenom should be used if
the type of snake cannot be
identified in all areas of
Australia apart from Tasmania,
where both tiger snake and
copperhead bite may be
successfully treated with tiger
snake antivenom.
■ Children are more likely to
sustain multiple bites and may
be more quickly and severely
affected by snakebite than
adults because of their lower
body weight.
■ The combination of
neurological disturbance and
evidence of defibrination in a
patient with an appropriate
history is strongly suggestive of
Severe envenomation
