The amount of Brown snake antivenom required to properly neutralise the venom delivered in a brown snake bite remains controversial. Using appropriate amounts reduces the risks and side effects of antivenom, while optimising its positive effects. One of the major clinical symptoms of Brown snake bite is massive bleeding. We aim to use a novel method for analysis of blood clotting (the ROTEM analyser) to study the effects of Brown snake venom on blood clotting and how different doses of antivenom affect this. This information may enable us to develop a simple point of care test to determine the optimal dose of antivenom to be given, reducing the amount of antivenom needed, the length of hospital stay, and therefore overall cost of snake bite management.
The project increased understanding of the action of venom in brown snake bites, of which one of the major clinical symptoms is massive bleeding. Brown snake venom appears to act rapidly and completely with blood, and the addition of antivenom after venom reaction did not seem to alter this reaction.
This finding reinforces the role of early, effective first aid to allow time to administer antivenom. The project also demonstrated that the use of ROTEM thromboelastography may identify early envenomation that is not detected by standard laboratory tests.
ROTEM analysis is now being done on each snake bite envenomation in both Townsville University Hospital and Cairns Base Hospital.
Dr Adam Holyoak
Dr Mark Little
A/Prof Jamie Seymour