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Tiger snake (Notechis spp) envenoming: Australian Snakebite Project (ASP-13)

In reply: A low-volume, polyvalent antivenom for brown and tiger snake envenoming would make treatment simpler and safer.

Since 2001, when information cited by Paul was published, there have been over 15 peer-reviewed research publications addressing the issue of antivenom dosing.13 There is now consistent evidence that one vial is equivalent to larger doses, and there have been no cases of active venom being present after one vial of antivenom.13 This research has led to updated Australian guidelines for antivenom dosing.4,5

We reported the results of the snake venom detection kit (sVDK) by the treating hospital and proved that many incorrect diagnoses were made in real-life conditions.3 Most operators would not have received training and in rural and remote hospitals, clinicians need to cover the most likely snakes consistent with the clinical picture. We recommend using the correct antivenom for all snakes but…

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