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Treatment of snakebite in Australia: gathering the evidence

Mark Little
Med J Aust 2013; 199 (11): 723-724.
doi:
10.5694/mja13.11111

New recommendations to help standardise care of people bitten by snakes in Australia

Mark Little, FACEM, MPH&TM, DTM&H, Emergency Physician and Clinical Toxicologist
School of Public Health, Tropical Medicine & Rehabilitation Sciences, James Cook University, Cairns, QLD.
Article References: 
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Currie BJ. Snakebite in tropical Australia: a prospective study in the “Top End” of the Northern Territory. Med J Aust 2004; 181: 693-697.
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Isbister GK, Brown SGA, Page CB, et al. Snakebite in Australia: a practical approach to diagnosis and treatment. Med J Aust 2013; 199: 763-768.<eMJA full text>
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Punguyire D, Iserson KV, Stolz U, Apanga S. Bedside whole-blood clotting times: validity after snakebites. J Emerg Med 2013; 44: 663-667.
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Isbister GK, Maduwage K, Shahmy S, et al. Diagnostic 20-min whole blood clotting test in Russell’s viper envenoming delays antivenom administration. QJM 2013; 106: 925-932.
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White J. A clinician’s guide to Australian venomous bites and stings: incorporating the updated CSL Antivenom Handbook. Melbourne: CSL Ltd, 2013.
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Isbister GK, O’Leary MA, Elliott M, Brown SG. Tiger snake (Notechis spp) envenoming: Australian Snakebite Project (ASP-13). Med J Aust 2012; 197: 173-177.
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Johnston CI, Brown SG, O’Leary MA, et al. Mulga snake (Pseudechis australis) envenoming: a spectrum of myotoxicity, anticoagulant coagulopathy, haemolysis and the role of early antivenom therapy - Australian Snakebite Project (ASP-19). Clin Toxicol (Phila) 2013; 51: 417-424.
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Allen GE, Brown SG, Buckley NA, et al. Clinical effects and antivenom dosing in brown snake (Pseudonaja spp.) envenoming – Australian Snakebite Project (ASP-14). PLOS One 2012; 7: e53188.
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Barrett R, Little M. Five years of snake envenoming in far north Queensland. Emerg Med (Fremantle) 2003; 15: 500-510.
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Henderson A, Baldwin LN, May C. Fatal brown snake (Pseudonaja textilis) envenomation despite the use of antivenom. Med J Aust 1993; 158: 709-710.
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Isbister GK, Buckley NA, Page CB, et al. A randomized controlled trial of fresh frozen plasma for treating venom-induced consumption coagulopathy in cases of Australian snakebite (ASP-18). J Thromb Haemost 2013; 11: 1310-1318.
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Johnston CI, O’Leary MA, Brown SG, et al. Death adder envenoming causes neurotoxicity not reversed by antivenom – Australian Snakebite Project (ASP-16). PLOS Negl Trop Dis 2012; 6: e1841.
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