We report a 44-year-old Western Australian man who suffered a cardiac arrest several hours after a bite by a brown snake. He was successfully resuscitated after bolus administration of undiluted brown snake antivenom. We suggest that an initial bolus dose of at least five ampoules (5000 units) of undiluted brown snake antivenom should be given as primary therapy for cardiac arrest following brown snake envenomation in Western Australia. (MJA 2002; 177: 646-649)
Brown snakes are the leading cause of both snakebites and snakebite fatalities in Australia.1,2 The characteristic feature of significant envenomation by brown snakes is defibrination coagulopathy caused by potent procoagulants in the venom. However, the cause of cardiac arrest after this envenomation is unclear.
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