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Snakebite in Australia: a practical approach to diagnosis and treatment

Australian snake envenoming is rare but potentially life-threatening and challenging to manage.1,2 Issues to be considered include the natural history of clinical envenoming, appropriate investigation and exclusion of envenoming in suspected snakebite cases,1 choice and dosing of antivenom, and ancillary treatments.3

Clinical effects

Most snakebites do not result in clinical envenoming1,2,4 because insufficient venom is injected (ie, a dry bite) or because the snake is non-venomous. Clinical envenoming may include local effects, systemic symptoms and major toxin syndromes — venom-induced consumption coagulopathy (VICC), neurotoxicity and myotoxicity (Box 1).2,10 Local effects are uncommon in Australian snakebite and are minimal for bites by brown snakes, which cause most major…