CSL Antivenom Handbook

Medical Treatment of Bites and Stings

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Treatment

The treatment of a case of envenoming will be determined by both animal and patient factors. Not all patients bitten/stung by dangerously venomous animals will be envenomed. Antivenom is not needed in every case. Rates of antivenom use will vary from animal to animal. Amongst those cases requiring antivenom therapy, there will be a considerable variation in the amount of antivenom needed. The information given in this book can be a guide only. Every case needs to be individually assessed.

Basics

Any patient presenting for treatment of a suspected bite/sting should be rapidly triaged and if there is significant impairment of cardiovascular or respiratory function, management of this takes priority. For potentially life threatening bites/stings (eg snakebite, funnel web spider bite, box jellyfish stings) it is important to obtain good venous access early, with a catheter or drip set, and this is a good opportunity to take initial blood samples for laboratory tests, if indicated (particularly in snakebite). If there is a pressure immobilisation bandage in use as first aid, leave it on until ready to treat envenoming. For potentially life threatening envenoming (eg snakebite, funnel web spider bite, blue ringed octopus bite, box jellyfish sting) the first aid should never be removed to inspect the wound if antivenom and treatment facilities are not immediately available.

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