Charles Darwin University

CDU eSpace
Institutional Repository

 
CDU Staff and Student only
 

Treatment of snakebite in Australia: The current evidence base and questions requiring collaborative multicentre prospective studies

Currie, Bart J. (2006). Treatment of snakebite in Australia: The current evidence base and questions requiring collaborative multicentre prospective studies. Toxicon,48(7):941-956.

Document type: Journal Article
Citation counts:
Google Scholar Search Google Scholar

IRMA ID 10139xPUB101
Title Treatment of snakebite in Australia: The current evidence base and questions requiring collaborative multicentre prospective studies
Author Currie, Bart J.
Journal Name Toxicon
Publication Date 2006
Volume Number 48
Issue Number 7
ISSN 0041-0101   (check CDU catalogue open catalogue search in new window)
Start Page 941
End Page 956
Total Pages 16
Place of Publication UK
Publisher Pergamon
Field of Research 1115 - Pharmacology and Pharmaceutical Sciences
HERDC Category C1 - Journal Article (DEST)
Abstract Despite the wealth of anecdotes and case reports there are fundamental questions of management of snakebite in Australia that remain unresolved or for which the current evidence is limited. The efficacy in the field, potential limitations and possibility of improvements in pressure immobilisation first aid need objective studies in humans. Optimal bandage sizes, stretch and pressure for different sized limbs need further evaluation, as does the use of pressure pads. Better definitions of specific clinical envenoming syndromes attributable to individual snake species are required, including elucidation of within-genus variations, similarities and differences. Venom studies suggest this is especially important for species within the brown snake (Pseudonaja) and death adder (Acanthophis) genera. Appropriate antivenom types, doses and dosing intervals for individual snake species should be more formally studied in patients. Especially important are confirmation of the need for higher doses of brown snake antivenom, while possibly limiting unnecessarily high doses, confirmation of the critical importance of early antivenom use to prevent pre-synaptic neurotoxicity in Taipan and tiger snake bites and ascertainment of whether larger doses of antivenom are unhelpful in Taipan bites after specified time delays. Confirmation of clinical efficacy and dosing recommendations for use of tiger snake (Notechis) antivenom in envenoming from Australian copperhead (Austrelaps spp.), broad headed (Hoplocephalus spp.) and rough-scaled snakes (Tropidechis carinatus) also require formal study in patients. Other examples of clinical relevance of cross-specificity of current and future monospecific antivenoms and whether there are geographical variations in antivenom responses within species will require elucidation. Prospective multicentre collaborative studies with predefined data collection and serial venom level assays are proposed as the way forward in Australia to help resolve therapeutic uncertainties and to establish a firmer evidence base for best-practice treatment guidelines for Australasian elapid snakebite.
DOI http://dx.doi.org/10.1016/j.toxicon.2006.07.015   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
Versions
Version Filter Type
Access Statistics: 47 Abstract Views  -  Detailed Statistics
Created: Fri, 12 Sep 2008, 08:35:25 CST by Administrator